Fear-avoidance behavior and anticipation of pain in patients with chronic low back pain: A randomized controlled study.

Investigated whether pain anticipation (PA) and fear-avoidance beliefs (FABs) will lead to behavioral avoidance. 50 patients (mean age 41.4 yrs) with chronic low back pain performed a simple leg-flexion task. Before the test, members of a control group were informed that the movement would not result in any increase of pain, whereas experimental group subjects were told that a slight increase of pain could occur. All patients completed the Fear-Avoidance-Beliefs Questionnaire and the Pain Disability Index. As dependent variables, different behavioral performance parameters were registered by a computerized protocol: number of flexion movements, mean range of motion, and mean work ratio. Furthermore, patients were asked about their pain intensity as well as their fear (at the moment) and finally were asked to judge the unpleasantness of the experiment (using visual analogue scales for each of the 3 variables). Results show that inducing PA by instruction led to significantly lower levels of behavioral performance as well as increased pain intensity and fear during the test. Behavioral performance was significantly correlated with FABs. Results confirm that PA and FABs significantly influence the behavior of patients with low back pain in that they motivate avoidance behavior. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Accession Number: 2002-15722-001. PMID: 15102230 Partial author list: First Author & Affiliation: Pfingsten, Michael; U Göttingen, Ctr of Anesthesiology, Dept of Algesiology, Göttingen, Germany. Other Publishers: Oxford University Press; Wiley-Blackwell Publishing Ltd. Release Date: 20020911. Correction Date: 20160222. Publication Type: Journal (0100), Peer Reviewed Journal (0110). Format Covered: Print. Document Type: Journal Article. Language: English. Major Descriptor: Avoidance; Back Pain; Chronic Pain; Expectations; Fear. Minor Descriptor: Motor Performance; Pain Perception. Classification: Physical & Somatoform & Psychogenic Disorders (3290). Population: Human (10); Male (30); Female (40); Outpatient (60). Location: Germany. Age Group: Adulthood (18 yrs & older) (300). Methodology: Empirical Study. References Available: Y. Page Count: 8. Issue Publication Date: Dec, 2001.