Open Access Research article

Self-reported pain and disability outcomes from an endogenous model of muscular back pain

Mark D Bishop13*, Maggie E Horn2, Steven Z George13 and Michael E Robinson34

Author Affiliations

1 Department of Physical Therapy, University of Florida, Gainesville, Florida, USA

2 Rehabilitation Doctoral Program, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA

3 Center for Pain and Behavioral Health, University of Florida, Gainesville, Florida, USA

4 Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA

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BMC Musculoskeletal Disorders 2011, 12:35  doi:10.1186/1471-2474-12-35

Published: 2 February 2011



Our purpose was to develop an induced musculoskeletal pain model of acute low back pain and examine the relationship among pain, disability and fear in this model.


Delayed onset muscle soreness was induced in 52 healthy volunteers (23 women, 17 men; average age 22.4 years; average BMI 24.3) using fatiguing trunk extension exercise. Measures of pain intensity, unpleasantness, and location, and disability, were tracked for one week after exercise.


Pain intensity ranged from 0 to 68 with 57.5% of participants reporting peak pain at 24 hours and 32.5% reporting this at 48 hours. The majority of participants reported pain in the low back with 33% also reporting pain in the legs. The ratio of unpleasantness to intensity indicated that the sensation was considered more unpleasant than intense. Statistical differences were noted in levels of reported disability between participants with and without leg pain.

Pain intensity at 24 hours was correlated with pain unpleasantness, pain area and disability. Also, fear of pain was associated with pain intensity and unpleasantness. Disability was predicted by sex, presence of leg pain, and pain intensity; however, the largest amount of variance was explained by pain intensity (27% of a total 40%). The second model, predicting pain intensity only included fear of pain and explained less than 10% of the variance in pain intensity.


Our results demonstrate a significant association between pain and disability in this model in young adults. However, the model is most applicable to patients with lower levels of pain and disability. Future work should include older adults to improve the external validity of this model.