Heavy Focus on Pain can Increase Risk of Chronic Back Pain
Date: 25th June 2025 | By: Dr Lourdes Gaspar
Hypervigilance to Pain May Predict the Transition from Subacute to Chronic Back Pain: A Longitudinal Observational Study
Department of Neuropsychology and Psychological Resilience Research, Research Group Learning and Brain Plasticity in Mental Disorders, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany;
This study looked at why some people with back pain that lasts a few weeks (called subacute back pain) go on to develop long-term, or chronic, back pain. Chronic back pain can seriously affect a person’s daily life, work, and mental health. The researchers wanted to find out if looking at more than just physical symptoms—like including emotional and social factors—could help predict who might develop chronic pain.
They followed 75 people with back pain that had lasted between 7 and 12 weeks. At the start, participants filled out several questionnaires that measured things like how much pain they were in, how they felt emotionally (e.g., stress, anxiety, depression), how they behaved when in pain (e.g., avoiding activity), and how much support they got from others. Six months later, the researchers checked in to see how much pain the participants were still experiencing and how much it was interfering with their lives.
One of the main tools used was the Örebro Musculoskeletal Pain Questionnaire (ÖMPQ), which is commonly used to predict long-term pain problems. But the researchers also looked at other factors, especially pain hypervigilance—which means being overly focused on or sensitive to pain.
They found that while the ÖMPQ was helpful at first, its ability to predict long-term pain faded once they accounted for how much pain people had at the beginning. In contrast, pain hypervigilance stood out as a strong and consistent predictor of who would still be in pain six months later. People who were more focused on their pain early on were more likely to have worse pain and more disruption to their lives later.
Interestingly, pain hypervigilance seemed to play a double role. On one hand, it was linked to getting more support from others and staying active. On the other hand, it was also tied to negative thoughts and behaviours, like catastrophizing (expecting the worst) and avoiding activity. Over time, this focus on pain could shift from being helpful to harmful, increasing the risk of chronic pain.
The study suggests that paying close attention to how people think and feel about their pain—especially how much they focus on it—can help doctors and therapists identify those at risk of developing chronic back pain.
We believe interventions like cognitive-behavioural therapy or attention training, which is part of Acceptance Commitment Therapy might help people manage their pain better and avoid long-term problems.