Pain‐related fear in acute low back pain: the first two weeks of a new episode

Sieben, Judith M.; Tuerlinckx, Sandrine; Portegijs, Piet J. M.

doi:10.1053/eujp.2002.0341

Cited by 104 publications

(66 citation statements)

References 26 publications

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“…Consistent with this model, acute and chronic low back pain patients with high pain-related fear typically show submaximal performance on a variety of physical challenges such as straight leg raise, knee-extension-flexion, trunkextension-flexion, and weight lifting [1,2,5,7,11,12,16,30,34,38,41]. These findings suggest that performance during forward bend tasks, as measured by thoracic, lumbar and hip excursions, may be influenced by individual differences in pain-related fear.…”

Section: Introductionsupporting

confidence: 53%

“…1 The effects of group and day on the peak to peak joint excursions of the lumbar spine are depicted PASS, TSK, and PCS), suggesting a robust and potentially important clinical finding. Although pain-related fear has previously been related to submaximal performance on a variety of physical challenges [1,2,5,7,11,12,16,30,34,35,38,41] a unique feature of this study is a mapping of this construct to joint movements during performance of a routine assessment procedure for patients with low back pain. Specifically, at each testing session participants with high levels of fear displayed less lumbar flexion during forward bending, even after statistically controlling for pain.…”

Section: Discussionmentioning

confidence: 99%

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The relationship between pain-related fear and lumbar flexion during natural recovery from low back pain

Thomas

France

2007

Eur Spine J

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Pain-related fear has been associated with avoidance behavior and increased risk for chronic low back pain; however, few studies have examined how pain-related fear relates specifically to motion of the spine following an acute episode of back pain. Thirty-six participants with a recent episode of low back pain were recruited from the general population using a combination of fliers and radio advertisements. To explore the natural recovery from low back pain we recruited individuals who were not seeking medical care. Participants performed a forward bending task at 3, 6, and 12 weeks following onset of low back pain. Three-dimensional joint motions of the spine and hip were recorded using an electromagnetic tracking device. Initial assessments of low back pain and pain-related fear were then correlated with joint excursions observed during each forward bending. Lumbar motion was inversely related to pain-related fear, but not low back pain, at all three testing sessions. In contrast, hip motion was inversely related to pain at all three testing sessions but was not related to fear. These findings suggest that pain-related fear results in avoidance behavior that specifically limits or restricts motion of the lumbar spine.

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Section: Introductionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

The relationship between pain-related fear and lumbar flexion during natural recovery from low back pain

Thomas

France

2007

Eur Spine J

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“…191, 296, 302 Prospective studies suggest fear-avoidance beliefs are predictive of the development of chronic low back pain. 108, 109, 177, 268 As a result, identification of elevated fear-avoidance beliefs has been suggested to as an important component in the assessment of low back pain. The Fear-Avoidance Beliefs Questionnaire (FABQ) is commonly used to assess fear-avoidance beliefs in patients with LBP and has physical activity (FABQ-PA) and work (FABQ-W) scales.…”

Section: Clinical Guidelines: Examinationmentioning

confidence: 99%

Low Back Pain

Delitto¹,

George²,

Dillen³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

783

352

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“…2,4,22 In addition, several longitudinal studies indicated that elevated pain-related fear is a precursor to poor clinical outcomes. 7,13,20 In my opinion, the FAMEPP has had a meaningful impact on the study of musculoskeletal pain because it clearly hypothesized that elevated pain-related fear and associated avoidance were not adaptive responses and, in fact, had the potential to significantly contribute to the development and maintenance of chronic pain and disability. …”

mentioning

confidence: 99%

Fear: A Factor to Consider in Musculoskeletal Rehabilitation

George¹

2006

J Orthop Sports Phys Ther

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F ear is a universal and powerful emotion and, as a result, it can have a profound impact on human behavior. A common assumption is that fear motivated behavior is in the best interest of the individual or group. However, literary and historical quotations suggest deleterious consequences can be associated with behaviors primarily motivated by fear. For example, François La Rochefoucauld (1613-1680) penned, ''We promise according to our hopes and perform according to our fears.'' In addition, Franklin Roosevelt famously delivered, ''The only thing we have to fear is fear itself-nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance,'' during his 1933 inaugural speech.Then it is not surprising to consider that fear-motivated behavior has the potential to adversely impact rehabilitation outcomes for patients with musculoskeletal pain. In 1983, a group of psychologists, physical therapists, and occupational therapists presented a theoretical model that described the influence fear had on pain outcomes. 15 Specifically, Lethem et al 15 proposed the Fear-Avoidance Model of Exaggerated Pain Perception (FAMEPP), and hypothesized that pain-related fear was integral to the development of chronic musculoskeletal pain syndromes.The central tenet of the FAMEPP was that pain perception had sensory and emotional reaction components. 15 The sensory component of pain was mediated by physiological factors related to the level of nociceptive input. The emotional reaction component of pain was mediated by psychological factors primarily related to fear of pain. Patients with lower levels of pain-related fear were hypothesized to have a synchronous relationship between sensory and emotional reaction components. Confrontation of pain symptoms was expected with a synchronous relationship and this was believed to be an adaptive response, resulting in a timely return to prior functional levels. 15 In contrast, patients with higher levels of pain-related fear were hypothesized to have a desynchronous relationship between the 2 pain components. Avoidance of pain symptoms was expected with a desynchronous relationship and this was believed to be a maladaptive response, associated with exaggerated pain perception and, eventually, chronic disability. 15These theoretical delineations made the FAMEPP amenable to hypothesis testing and, subsequently, numerous empirical studies reported in the peer review literature have supported the theoretical structure of the model for patients with musculoskeletal pain. Cross-sectional studies consistently documented a positive association between elevated pain-related fear and increased pain intensity and disability. 2,4,22 In addition, several longitudinal studies indicated that elevated pain-related fear is a precursor to poor clinical outcomes. 7,13,20 In my opinion, the FAMEPP has had a meaningful impact on the study of musculoskeletal pain because it clearly hypothesized that elevated pain-related fear and associated avoidance were not adaptive respon...

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Pain‐related fear in acute low back pain: the first two weeks of a new episode

Cited by 104 publications

References 26 publications

The relationship between pain-related fear and lumbar flexion during natural recovery from low back pain

The relationship between pain-related fear and lumbar flexion during natural recovery from low back pain

Low Back Pain

Fear: A Factor to Consider in Musculoskeletal Rehabilitation

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