Man Ther. 1999 Nov; 4(4): 187-95.

Fear of movement/(re)injury, avoidance and pain disability in chronic low back pain patients.

Vlaeyen JW, Crombez G.

Department of Medical, Clinical and Experimental Psychology, Maastricht University, The Netherlands.

Chronic pain syndromes such as chronic low back pain are responsible for enormous costs for health care and society. For these conditions a pure biomedical approach often proves insufficient. Numerous studies have shown that there is little direct relationship between pain and disability and suggest that the biopsychosocial approach offers the foundations for a better insight in how pain can become a persistent problem. The main assumption is that pain and pain disability are not only influenced by organic pathology, if found, but also by psychological and social factors. In this contribution, a behavioural analysis of chronic musculoskeletal pain will be discussed, with special attention to the role of pain-related fear in the development and maintenance of chronic pain disability, and the behavioural rehabilitation perspective of chronic pain management.