Comparison of Kinesiophobia and Disability Among Lower Back Pain Patients with or Without Weightlifting Practices

Background: Low back pain (LBP) is a prevalent musculoskeletal condition with significant global health implications. While physical activity is generally advocated for its management, the psychological impact of exercise, particularly weightlifting, on disability and fear-avoidance beliefs in LBP remains underexplored in the Pakistani context. Objective: To compare kinesiophobia and functional disability levels among individuals with chronic non-specific LBP who engage in regular weightlifting versus those with sedentary lifestyles, assessing whether structured resistance training offers protective or changing effects. Methods: This comparative cross-sectional study included 308 participants aged 20–50 years (n = 155 weightlifters; n = 153 sedentary). Inclusion criteria were non-specific LBP ≥3 months, while those with spinal surgery, deformities, pregnancy, or neurological conditions were excluded. Data were collected via structured interviews using the Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire (FABQ-Brazil), and Back Pain and Body Posture Evaluation Instrument (BackPEI-A). Ethical approval was obtained from the Institutional Review Board [IRB no.], and procedures followed the Helsinki Declaration. Statistical analysis was conducted using SPSS v27, employing independent t-tests and Chi-square tests. Results: Weightlifters reported significantly lower mean ODI scores (18.3 ± 11.6 vs. 27.6 ± 14.2; p < 0.001) and lower kinesiophobia prevalence (7.1% vs. 14.9%; p = 0.013). Mild pain was more frequent among weightlifters (55.1%) compared to sedentary individuals (15.6%). Conclusion: Regular weightlifting is associated with reduced disability and fear-avoidance behavior in individuals with LBP, supporting its integration into rehabilitation protocols to enhance psychological and functional outcomes in musculoskeletal healthcare.