Importance of fear-avoidance behavior in chronic non-specific low back pain
- PMID: 20555121
- DOI: 10.3233/BMR-2010-0249
Importance of fear-avoidance behavior in chronic non-specific low back pain
Abstract
International classification of Functioning, Disability and Health has adapted a biopsychosocial model for management of chronic low back pain patient (CLBP). The influence of psychological factors seems to be important in the transition from acute to chronic low back pain (> 3 months). In particular, pain-related fear and pain catastrophizing are believed to be important factors for disability. A number of studies have shown that pain-related fear is a strong predictor of self-reported disability in both acute and chronic low back pain. This situation has led to the dependency of clinicians on radio-diagnostic procedures for decision making, which often increases the financial burden. Research has evidenced that physicians and physical therapists, often fail to recognize psychological illnesses. The aim of this article is to describe the importance of fear avoidance behavior and to evaluate the immediate effect of cognitive behavioral therapy (CBT) during evaluation of patients with CLBP. An initial physical examination of a 24-year old female patient with CLBP, showed painful guarded movements over the lumbo-pelvic region, but the outcomes of her Fear-Avoidance Belief Questionnaire (FABQ) showed strong cues for psychological illness. Based on clinical reasoning, the patient was educated in terms of cognitive reconstruction. Interestingly after some CBT sessions, her spine guarding pattern was disappeared and that helped us to carry a more specific physical examination. After a few weekly therapeutic sessions of CBT, significant changes were seen in all outcome measures. It has been concluded that probably, by using specific biopsychosocial training, positive results in fear avoidance behavior can be achieved. Hence the psychotherapeutic management approach is considered as a useful economical tool in low back pain.
Similar articles
-
[The role of an information booklet or oral information about back pain in reducing disability and fear-avoidance beliefs among patients with subacute and chronic low back pain. A randomized controlled trial in a rehabilitation unit].Ann Readapt Med Phys. 2006 Nov;49(8):600-8. doi: 10.1016/j.annrmp.2006.05.003. Epub 2006 May 26. Ann Readapt Med Phys. 2006. PMID: 16793163 Clinical Trial. French.
-
Clinical course and impact of fear-avoidance beliefs in low back pain: prospective cohort study of acute and chronic low back pain: II.Spine (Phila Pa 1976). 2006 Apr 20;31(9):1038-46. doi: 10.1097/01.brs.0000214878.01709.0e. Spine (Phila Pa 1976). 2006. PMID: 16641782
-
[Low back pain: from symptom to chronic disease].Z Orthop Ihre Grenzgeb. 2004 Mar-Apr;142(2):146-52. doi: 10.1055/s-2004-822622. Z Orthop Ihre Grenzgeb. 2004. PMID: 15106058 Review. German.
-
The effect of a fear-avoidance-based physical therapy intervention for patients with acute low back pain: results of a randomized clinical trial.Spine (Phila Pa 1976). 2003 Dec 1;28(23):2551-60. doi: 10.1097/01.BRS.0000096677.84605.A2. Spine (Phila Pa 1976). 2003. PMID: 14652471 Clinical Trial.
-
Fear of movement/(re)injury, avoidance and pain disability in chronic low back pain patients.Man Ther. 1999 Nov;4(4):187-95. doi: 10.1054/math.1999.0199. Man Ther. 1999. PMID: 10593107 Review.
Cited by
-
Impact of central sensitization on pain, disability and psychological distress in patients with knee osteoarthritis and chronic low back pain.BMC Musculoskelet Disord. 2023 Nov 10;24(1):877. doi: 10.1186/s12891-023-07019-z. BMC Musculoskelet Disord. 2023. PMID: 37950225 Free PMC article.
-
How to objectively assess and observe maladaptive pain behaviors in clinical rehabilitation: a systematic search and review.Arch Physiother. 2021 Jun 3;11(1):15. doi: 10.1186/s40945-021-00109-y. Arch Physiother. 2021. PMID: 34078473 Free PMC article. Review.
-
Inclusion and exclusion criteria used in non-specific low back pain trials: a review of randomised controlled trials published between 2006 and 2012.BMC Musculoskelet Disord. 2018 Apr 12;19(1):113. doi: 10.1186/s12891-018-2034-6. BMC Musculoskelet Disord. 2018. PMID: 29650015 Free PMC article.
-
The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back.BMJ Open Sport Exerc Med. 2015 Nov 9;1(1):e000050. doi: 10.1136/bmjsem-2015-000050. eCollection 2015. BMJ Open Sport Exerc Med. 2015. PMID: 27900136 Free PMC article.
-
A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain.Healthcare (Basel). 2016 Apr 25;4(2):22. doi: 10.3390/healthcare4020022. Healthcare (Basel). 2016. PMID: 27417610 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources