Journal of Behavioral Medicine

, Volume 30, Issue 1, pp 77–94 | Cite as

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

  • Maaike Leeuw
  • Mariëlle E. J. B. Goossens
  • Steven J. Linton
  • Geert Crombez
  • Katja Boersma
  • Johan W. S. Vlaeyen
Review Paper

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 model low back pain pain catastrophizing disability exposure in vivo 

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Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Maaike Leeuw
    • 1
  • Mariëlle E. J. B. Goossens
    • 1
  • Steven J. Linton
    • 2
  • Geert Crombez
    • 3
  • Katja Boersma
    • 2
  • Johan W. S. Vlaeyen
    • 1
    • 4
  1. 1.Department of Medical, Clinical, and Experimental PsychologyMaastricht UniversityMaastrichtThe Netherlands
  2. 2.Department of Behavioral, Social, and Legal Sciences-PsychologyÖrebrö UniversityÖrebröSweden
  3. 3.Department of Experimental-Clinical and Health PsychologyGhent UniversityGhentBelgium
  4. 4.Pain Management and Research CentreUniversity Hospital MaastrichtMaastrichtThe Netherlands

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