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The role of fear of movement/(re)injury in pain disability

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Abstract

It is now well established that in chronic low back pain, there is no direct relationship between impairments, pain, and disability. From a cognitive-behavioral perspective, pain disability is not only influenced by the organic pathology, but also by cognitive-perceptual, psychophysiological, and motoric-environmental factors. This paper focuses on the role of specific beliefs that are associated with avoidance of activities. These beliefs are related to fear of movement and physical activity, which is (wrongfully) assumed to cause (re)injury. Two studies are presented, of which the first examines the factor structure of the Tampa Scale for Kinesiophobia (TSK), a recently developed questionnaire that is aimed at quantifying fear of movement/(re)injury. In the second study, the value of fear of movement/(re)injury in predicting disability levels is analyzed, when the biomedical status of the patient and current pain intensity levels are controlled for. In addition, the determinants of fear of movement/(re)injury are examined. The discussion focuses on the clinical relevance of the fear-avoidance model in relation to risk assessment, assessment of functional capacity, and secondary prevention.

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Authors and Affiliations

  1. Institute for Rehabilitation Research, Zandbergsweg 111, 6432, CC Hoensbroek, The Netherlands

    Johan W. S. Vlaeyen, Ank M. J. Kole-Snijders & Annemarie M. Rotteveel

  2. Department of Medical Psychology, University of Limburg, PO Box 616, 6400, MD Maastricht, The Netherlands

    Johan W. S. Vlaeyen

  3. Lucas Foundation for Rehabilitation, Zandbergsweg 111, 6432, CC Hoensbroek, The Netherlands

    Renske Ruesink & Peter H. T. G. Heuts

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  1. Johan W. S. Vlaeyen
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  2. Ank M. J. Kole-Snijders
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  5. Peter H. T. G. Heuts
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Vlaeyen, J.W.S., Kole-Snijders, A.M.J., Rotteveel, A.M. et al. The role of fear of movement/(re)injury in pain disability. J Occup Rehab 5, 235–252 (1995). https://doi.org/10.1007/BF02109988

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