Fear avoidance model – review of selected reports

Abstract

SUMMARY: Based on the bio-psycho-social approach, fear-avoidance model can be used in situations when somebody avoids movement because of fear of pain. This model can be applied in groups of patients with low back pain and musculoskeletal pain and explains how acute pain becomes chronic. A simple behavioral model of classical and operant conditioning that explains activity avoidance was developed into a more sophisticated, cognitive-behavioral fear-avoidance model, postulating the existence of a vicious circle that causes increasing disability of patients in chronic pain. The variables involved in this mechanism are catastrophizing, fear of activity, avoiding movement, increased distress and fear-avoidance beliefs. This article also presents some further improvements to the model that include pain intensity and motivational theory. A brief overview of tools used in research on fear-avoidance is also presented. It is recommended to take Fear Avoidance Model in to consideration when working with patients with no improvement and the risk of recurrent episodes of pain. Further studies are needed to empirically verify the fear-avoidance model.