- Use of extended rest or disproportionate "downtime".
- Reduced activity level with significant withdrawal from activities of daily living, particularly work.
- Irregular participation or poor compliance with physical exercise or activity.
- Tendency for activities to be in a "boom-bust" or "do too much-pay for it later" cycle.
- Avoidance of normal activity and progressive substitution of a lifestyle away from work/productive activities.
- Has not returned to work within the usual time frame (outlined in clinical guidelines) for this injury type.
- Report of intense pain, that is, above 10 on a 0 to 10 scale.
- Excessive reliance on aids or appliances.
- Sleep quality reduced since the onset of pain.
- High intake of alcohol or other substances, possibly as self-medication, with an increase since the onset of pain.
- Smoking.
