Fear-avoidance model

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Fear-avoidance model

The fear-avoidance model is a model that describes how individuals develop chronic musculoskeletal pain as a result of avoidance of activities based on fear.[1][2] Introduced by Lethem et al. in 1983, this model helped explain how these individuals experience pain despite the absence of pathology.[2][3][4] If an individual experiences acute pain and manages the situation by using avoidant behavior, a lack of pain increase would reinforce this behavior.[5] However, this avoidant behavior may cause the individual to decrease exercise which may in turn lead to increased disability.[5] In 1993, Waddell et al. developed a Fear-Avoidance Beliefs Questionnaire (FABQ) which showed that fear-avoidance beliefs about physical activities are strongly related to work loss.[5][2][6]


  1. ^ Leeuw, M.; Goossens, M. L. E. J. B.; Linton, S. J.; Crombez, G.; Boersma, K.; Vlaeyen, J. W. S. (2006). "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence". Journal of Behavioral Medicine 30 (1): 77–94. doi:10.1007/s10865-006-9085-0. PMID 17180640.  edit
  2. ^ a b c Vlaeyen, J. W.; Linton, S. J. (2000). "Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art". Pain 85 (3): 317–332. doi:10.1016/s0304-3959(99)00242-0. PMID 10781906.  edit
  3. ^ Lethem, J.; Slade, P. D.; Troup, J. D.; Bentley, G. (1983). "Outline of a Fear-Avoidance Model of exaggerated pain perception--I". Behaviour research and therapy 21 (4): 401–408. PMID 6626110.  edit
  4. ^ From Acute to Chronic Back Pain. Oxford University Press. p. 282. ISBN 978-0-19-162572-5. Retrieved 19 July 2012. 
  5. ^ a b c Herbert H. Zaretsky; Edwin F. Richter; Myron G. Eisenberg (21 June 2005). Medical Aspects Of Disability: A Handbook For The Rehabilitation Professional. Springer Publishing Company. pp. 223–4. ISBN 978-0-8261-7973-9. Retrieved 19 July 2012. 
  6. ^ Waddell, G.; Newton, M.; Henderson, I.; Somerville, D.; Main, C. J. (1993). "A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability". Pain 52 (2): 157–168. doi:10.1016/0304-3959(93)90127-b. PMID 8455963.  edit