The lived experience of pain-related fear in people with chronic low back pain

Abstract

Low back pain (LBP) is a leading cause of disability worldwide. One of the strongest predictors of LBP disability is pain-related fear. The fear avoidance model (FAM) describes how the belief that pain signals damage to the spine can lead individuals into a cycle of fear and avoidance, which in turn sustain pain and physical and psychosocial disability. A large body of research has supported the relationships proposed by the FAM; however, randomized controlled trials based on the model have reported modest effect sizes for reductions in fear and disability. Limitations of the model in its current form may be impeding its clinical utility and applicability to the wider population of people wi..