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Fear of Pain as a Prognostic Factor in Chronic Pain: Conceptual Models, Assessment, and Treatment Implications

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Abstract

Chronic pain is a pervasive health care issue affecting over 50 million Americans and costing more than $100 billion dollars annually in lost productivity and health care costs. As a financially and emotionally taxing condition, the families and friends of people with chronic pain, as well as society at large, are affected. Current theory supports the role of biological, psychological, and environmental factors in the etiology, exacerbation, and maintenance of chronic pain. Recently, the specific role of pain-related fear in pain experience has received increasing attention. This article summarizes current understanding of the role of pain-related fear in the onset of acute pain incidents, the transition of acute pain to chronic, and the pain severity and disability of patients with ongoing chronic pain conditions. Treatments demonstrated to reduce pain-related fear are presented, evidence demonstrating their efficacy at reducing disability and pain severity are summarized, and recent criticisms of the fear-avoidance model and future directions are considered.

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Acknowledgments

The authors would like to thank Christina Kemp for her insightful editorial comments on an earlier draft of this article, and to Deven Wilson for assistance in creation of Fig. 1.

Disclosure

Dr. Dennis C. Turk, in the past 12 months, has served as a consultant to Eli Lily, Forrest Pharmaceuticals, Johnson & Johnson, Philips Respironics, Shire, and SK LifeScience; he has also received grants from Endo Pharmaceuticals and Johnson & Johnson. No other potential conflicts of interest relevant to this article were reported.

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  1. Department of Anesthesiology & Pain Medicine, University of Washington, Box 356540, Seattle, WA, 98195, USA

    Dennis C. Turk & Hilary D. Wilson

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Correspondence to Dennis C. Turk.

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Turk, D.C., Wilson, H.D. Fear of Pain as a Prognostic Factor in Chronic Pain: Conceptual Models, Assessment, and Treatment Implications. Curr Pain Headache Rep 14, 88–95 (2010). https://doi.org/10.1007/s11916-010-0094-x

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