Pain-related Fear in Chronic Low Back Pain Patients

The aim of the article is to review the evidence for the mediating role of pain-related fear, and its immediate and long-term consequences in the initiation and maintenance of chronic low back pain disability. Low back pain is one of the most frequent reasons why patients ask for consultation and are on sick leave. In these patients, pain-related fear can cause prolongation of chronic pain and create an important barrier to successful treatment. In many cases, fear leads to compelling functional damage. The "fear-avoidance" model described in the paper explains how and why some individuals with acute pain develop the chronic pain syndrome. Avoidance leads to reduction, continuation or exacerbation of fear and development of a phobic state. The article describes available cognitive-behavioural as sessment and psychotherapeutic methods of pain-related fear and avoidance.