title: The relationship between knowledge of pain neurophysiology and fear avoidance in people with chronic pain: A point in time, observational study.
abstract: Chronic pain is prevalent in the western world; however fear of pain often has a greater impact than the degree of initial injury. The aim of this study was to explore the relationship between knowledge of the neurophysiology of pain and fear avoidance in individuals diagnosed with chronic pain. Twenty-nine people with chronic musculoskeletal pain were recruited and completed questionnaires to determine their understanding of pain neurophysiology and the degree of their fear avoidance beliefs. There was an inverse relationship between knowledge of pain neurophysiology and the level of fear avoidance. Patients with higher pain knowledge reported less fear avoidance and lower perceived disability due to pain. There was no relationship with the educational level or compensable status for either variable. The findings suggest that fear avoidance is positively influenced by neurophysiology of pain education, so that a higher level of pain knowledge is associated with less activity-related fear. The clinical implication is that reducing fear avoidance/kinesiophobia using neurophysiology of pain education in people with chronic pain may provide an effective strategy to help manage fear avoidance and related disability in the chronic pain population in order to improve treatment outcomes.
authors.affiliation: a Physiotherapy Department , North Eastern Rehabilitation Centre , Ivanhoe , VIC , Australia.|d Department of Rehabilitation, Aged and Extended Care, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences , Flinders University , Adelaide , Australia.
authors.forename: Claire
authors.initials: C
authors.lastname: Fletcher
authors.affiliation: b Discipline of Physiotherapy , Graduate School of Health, University of Technology Sydney , Sydney NSW , Australia.|c Discipline of Physiotherapy, School of Health Sciences , Flinders University , Adelaide , SA , Australia.
authors.forename: Lynley
authors.initials: L
authors.lastname: Bradnam
authors.affiliation: d Department of Rehabilitation, Aged and Extended Care, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences , Flinders University , Adelaide , Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Barr
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001362:Avoidance Learning; D059350:Chronic Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D017281:Cost of Illness; D004185:Disability Evaluation; D005239:Fear; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007699:Kinesthesis; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D010147:Pain Measurement; D058748:Pain Perception; D010353:Patient Education as Topic; D011795:Surveys and Questionnaires
keywords: Chronic pain; fear avoidance; kinesiophobia; pain education; pain neurophysiology