Understanding Discrepancies in a Person’s Fear of Movement and Avoidance Behavior: a guide for musculoskeletal rehabilitation clinicians who support people with chronic musculoskeletal pain

Liesbet De Baets*, Ann Meulders, Stefaan Van Damme, J. P. Caneiro, Thomas Matheve

*Corresponding author for this work

Research output: Contribution to journalComment/Letter to the editorAcademicpeer-review

Abstract

BACKGROUND: Generic self-report measures do not reflect the complexity of a person’s pain-related behavior. Since variations in a person’s fear of movement and avoidance behavior may arise from contextual and motivational factors, a person-centered evaluation is required—addressing the cognitions, emotions, motivation, and actual behavior of the person. CLINICAL QUESTION: Most musculoskeletal rehabilitation clinicians will recognize that different people with chronic pain have very different patterns of fear and avoidance behavior. However, an important remaining question for clinicians is “How can I identify and reconcile discrepancies in fear of movement and avoidance behavior observed in the same person, and adapt my management accordingly?” KEY RESULTS: We frame a clinical case of a patient with persistent low back pain to illustrate the key pieces of information that clinicians may consider in a person-centered evaluation (ie, patient interview, self-report measures, and behavioral assessment) when working with patients to manage fear of movement and avoidance behavior. CLINICAL APPLICATION: Understanding the discrepancies in a person’s fear of movement and avoidance behavior is essential for musculoskeletal rehabilitation clinicians, as they work in partnership with patients to guide tailored approaches to changing behaviors.

Original languageEnglish
Pages (from-to)307–316
Number of pages29
JournalJournal of Orthopaedic & Sports Physical Therapy
Volume53
Issue number5
Early online date8 Mar 2023
DOIs
Publication statusPublished - May 2023

Cite this