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Background and Aims Chronic spinal pain is associated with various behavioral responses as individuals adapt to persistent pain. These behavioral patterns may influence functional outcomes and potentially perpetuate pain cycles. This study aimed to examine pain activity patterns in individuals with chronic spinal pain and compare pain duration and severity parameters across these different behavioral patterns.Methods This cross-sectional study included 109 individuals with chronic spinal pain persisting for more than six months. Participants’ sociodemographic characteristics and spinal pain regions were recorded. Pain severity was assessed using the Numerical Rating Scale, and daily activity patterns were evaluated with the Patterns of Activity Measure-Pain.Results The mean age of participants was 38.23±13.19 years, with 71.6% being female. The most common pain regions were lumbar (37.6%), cervical (33.0%), and cervicothoracic (15.6%). Participants were categorized into avoidance (n=40), overdoing (n=51) and pacing (n=18) behavior patterns according to the results of the Patterns of Activity Measure-Pain. Mean pain duration was 72.25±77.69 months in the avoidance group, 52.55±51.42 months in the overdoing group, and 46.17±52.36 months in the pacing group. No statistically significant differences were found between the three activity pattern groups in terms of pain duration or pain severity parameters (p>0.05).Abstract EP013 Table 1Pain parameters across different activity patterns in chronic spinal painConclusions Individuals exhibiting avoidance behavior demonstrated notably longer pain duration, suggesting potential clinical relevance despite the lack of statistical significance between activity patterns. This finding aligns with current literature indicating that fear-avoidance behaviors may contribute to pain chronification. Early identification of maladaptive activity patterns could be valuable in clinical assessment and intervention planning. For physiotherapists and pain specialists, understanding these behavioral adaptations may enhance the effectiveness of rehabilitation approaches and pain management strategies in chronic spinal pain patients, particularly in targeting and modifying avoidance behaviors early in the treatment process.