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    Beliefs underlying pain-related fear and how they evolve: a qualitative investigation in people with chronic back pain and high pain-related fear

    234960_234960.pdf (886.3Kb)
    Access Status
    Open access
    Authors
    Bunzli, Samantha
    Smith, Anne
    Schütze, R.
    O'Sullivan, Peter
    Date
    2015
    Type
    Journal Article
    
    Metadata
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    Citation
    Bunzli, S. and Smith, A. and Schütze, R. and O'Sullivan, P. 2015. Beliefs underlying pain-related fear and how they evolve: a qualitative investigation in people with chronic back pain and high pain-related fear. BMJ Open. 5 (10): e008847.
    Source Title
    BMJ Open
    DOI
    10.1136/bmjopen-2015-008847
    School
    School of Physiotherapy and Exercise Science
    Remarks

    This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by-nc/4.0/

    URI
    http://hdl.handle.net/20.500.11937/19205
    Collection
    • Curtin Research Publications
    Abstract

    OBJECTIVES: The fear-avoidance model describes how the belief that pain is a sign of damage leads to pain-related fear and avoidance. But other beliefs may also trigger the fear and avoidance responses described by the model. Experts have called for the next generation of fear avoidance research to explore what beliefs underlie pain-related fear and how they evolve. We have previously described damage beliefs and suffering/functional loss beliefs underlying high pain-related fear in a sample of individuals with chronic back pain. The aim of this study is to identify common and differential factors associated with the beliefs in this sample. DESIGN: A qualitative study employing semistructured interviews. SETTING: Musculoskeletal clinics in Western Australia. PARTICIPANTS: 36 individuals with chronic back pain and high scores on the Tampa Scale (mean 47/68). RESULTS: The overarching theme was a pain experience that did not make sense to the participants. The experience of pain as unpredictable, uncontrollable and intense made it threatening. Attempting to make sense of the threatening pain, participants with damage beliefs drew on past personal experiences of pain, societal beliefs, and sought diagnostic certainty. Met with diagnostic uncertainty, or diagnoses of an underlying pathology that could not be fixed, they were left fearful of damage and confused about how to 'fix' it. Participants with suffering/functional loss beliefs drew on past personal experiences of pain and sought help from healthcare professionals to control their pain. Failed treatments and the repeated failure to achieve functional goals left them unable to make 'sensible' decisions of what to do about their pain. CONCLUSIONS: The findings raise the suggestion that sense-making processes may be implicated in the fear-avoidance model. Future research is needed to explore whether fear reduction may be enhanced by considering beliefs underlying fear and providing targeted intervention to help individuals make sense of their pain.

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    • The lived experience of pain-related fear in people with chronic low back pain
      Bunzli, S.; Smith, Anne; Schütze, R.; O'Sullivan, P. (2017)
      Low back pain (LBP) is a leading cause of disability worldwide. One of the strongest predictors of LBP disability is pain-related fear. The fear avoidance model (FAM) describes how the belief that pain signals damage to ...
    • Making sense of low back pain and pain-related fear
      Bunzli, S.; Smith, Anne; Schütze, R.; Lin, I.; O'Sullivan, Peter (2017)
      SYNOPSIS: Pain-related fear is implicated in the transition from acute to chronic low back pain and the persistence of disabling low back pain, making it a key target for physical therapy intervention. The current ...
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      Bunzli, Samantha (2015)
      This qualitative, prospective study explores the lived experience of pain-related fear in people with chronic non-specific low back pain. Novel insights are provided into the beliefs underlying pain-related fear, how these ...
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