Journal of Behavioral Medicine

, Volume 30, Issue 1, pp 77–94

The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence

Authors

    • Department of Medical, Clinical, and Experimental PsychologyMaastricht University
  • Mariëlle E. J. B. Goossens
    • Department of Medical, Clinical, and Experimental PsychologyMaastricht University
  • Steven J. Linton
    • Department of Behavioral, Social, and Legal Sciences-PsychologyÖrebrö University
  • Geert Crombez
    • Department of Experimental-Clinical and Health PsychologyGhent University
  • Katja Boersma
    • Department of Behavioral, Social, and Legal Sciences-PsychologyÖrebrö University
  • Johan W. S. Vlaeyen
    • Department of Medical, Clinical, and Experimental PsychologyMaastricht University
    • Pain Management and Research CentreUniversity Hospital Maastricht
Review Paper

DOI: 10.1007/s10865-006-9085-0

Cite this article as:
Leeuw, M., Goossens, M.E.J.B., Linton, S.J. et al. J Behav Med (2007) 30: 77. doi:10.1007/s10865-006-9085-0

Research studies focusing on the fear-avoidance model have expanded considerably since the review by Vlaeyen and Linton (Vlaeyen J. W. S. & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85(3), 317--332). The fear-avoidance model is a cognitive-behavioral account that explains why a minority of acute low back pain sufferers develop a chronic pain problem. This paper reviews the current state of scientific evidence for the individual components of the model: pain severity, pain catastrophizing, attention to pain, escape/avoidance behavior, disability, disuse, and vulnerabilities. Furthermore, support for the contribution of pain-related fear in the inception of low back pain, the development of chronic low back pain from an acute episode, and the maintenance of enduring pain, will be highlighted. Finally, available evidence on recent clinical applications is provided, and unresolved issues that need further exploration are discussed.

KEY WORDS

Fear avoidance modellow back painpain catastrophizingdisabilityexposure in vivo

Copyright information

© Springer Science+Business Media, LLC 2006