title: Physical activity, fear avoidance, and chronic non-specific pain: A narrative review.
abstract: BACKGROUND
  Chronic non-specific pain (CNSP) and physical inactivity have become increasingly prevalent in the United States; however, the associations between the two remain unclear. The lack of clarity may be due to the presence of a third variable, the individual's pain coping strategy.
  
  
  OBJECTIVE
  We had three specific aims. 1) To review the associations between fear-avoidance beliefs and behaviors, and levels of physical activity and disability. 2) To review the theoretical mechanisms behind chronic non-specific pain and the potential mediating role of physical activity. 3) Finally, to report the most commonly recommended interventions for fear-avoidant individuals suffering with chronic pain.
  
  
  CONCLUSIONS
  Further investigation is needed to fully understand the associations between physical activity, chronic non-specific pain, and fear avoidant beliefs and behaviors. Precise relationships notwithstanding, there is strong evidence to suggest that physical activity is an integral piece to the chronic non-specific pain puzzle. For this reason, it is incumbent upon clinicians to strongly recommend participation in regular, yet properly progressed, physical activity to chronic non-specific pain sufferers.
authors.affiliation: Brooks College of Health, University of North Florida, 1UNF Drive/Bldg 39, Jacksonville, FL 32224, USA. Electronic address: Nicole.nelson@unf.edu.
authors.forename: Nicole
authors.initials: N
authors.lastname: Nelson
authors.affiliation: Brooks College of Health, University of North Florida, 1UNF Drive/Bldg 39, Jacksonville, FL 32224, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Churilla
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D001362:Avoidance Learning; D059350:Chronic Pain / Q000517:prevention & control / Q000523:psychology*; D015444:Exercise / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D057185:Sedentary Behavior; D014481:United States
keywords: Chronic non-specific pain; Exercise; Fear avoidance; Physical activity