Fear-avoidance beliefs—a moderator of treatment efficacy in patients with low back pain: a systematic review

Wertli, Maria M.; Rasmussen-Barr, Eva; Held, Ulrike; Weiser, Sherri; Bachmann, Lucas M.; Brunner, Florian

doi:10.1016/j.spinee.2014.02.033

Cited by 344Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationSpine and Intervertebral Disc Pathology

Fear-avoidance beliefs—a moderator of treatment efficacy in patients with low back pain: a systematic review

Wertli, Maria M., Rasmussen-Barr, Eva, Held, Ulrike, Weiser, Sherri, Bachmann, Lucas M., Brunner, Florian·2014·The Spine Journal

DOI 10.1016/j.spinee.2014.02.033

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Abstract

Background context Psychological factors are believed to influence the development of chronic low back pain. To date, it is not known how fear-avoidance beliefs (FABs) influence the treatment efficacy in low back pain.Purpose To summarize the evidence examining the influence of FABs measured with the Fear-Avoidance Belief Questionnaire or the Tampa Scale of Kinesiophobia on treatment outcomes in patients with low back pain.Study design/setting This is a systematic review.Patient sample Patients with low back pain.Outcome measures Work-related outcomes and perceived measures including return to work, pain, and disability.Methods In January 2013, the following databases were searched: BIOSIS, CINAHL, Cochrane Library, Embase, OTSeeker, PeDRO, PsycInfo, PubMed/Medline, Scopus, and Web of Science. A hand search of the six most often retrieved journals and a bibliography search completed the search.Study eligibility criteria, participants, and interventions research studies that included patients with low back pain who participated in randomized controlled trials (RCTs) investigating nonoperative treatment efficacy. Out of 646 records, 78 articles were assessed in full text and 17 RCTs were included. Study quality was high in five studies and moderate in 12 studies.Results In patients with low back pain of up to 6 months duration, high FABs were associated with more pain and/or disability (4 RCTs) and less return to work (3 RCTs) (GRADE high-quality evidence, 831 patients vs. 322 in nonpredictive studies). A decrease in FAB values during treatment was associated with less pain and disability at follow-up (GRADE moderate evidence, 2 RCTs with moderate quality, 242 patients). Interventions that addressed FABs were more effective than control groups based on biomedical concepts (GRADE moderate evidence, 1,051 vs. 227 patients in studies without moderating effects). In chronic patients with LBP, the findings were less consistent. Two studies found baseline FABs to be associated with more pain and disability and less return to work (339 patients), whereas 3 others (832 patients) found none (GRADE low evidence). Heterogeneity of the studies impeded a pooling of the results.Conclusions Evidence suggests that FABs are associated with poor treatment outcome in patients with LBP of less than 6 months, and thus early treatment, including interventions to reduce FABs, may avoid delayed recovery and chronicity. Patients with high FABs are more likely to improve when FABs are addressed in treatments than when these beliefs are ignored, and treatment strategies should be modified if FABs are present.

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In patients with low back pain, high fear-avoidance beliefs are associated with more pain and/or disability and lower likelihood to return to work.
“In patients with low back pain, high fear-avoidance beliefs were associated with more pain and/or disability and lower likelihood to return to work [43].”
From Acceptance and commitment therapy for chronic pain: Protocol of a systematic review and individual participant data meta-Analysis (2019) · cites this paper as [43]

R: A Language and Environment for Statistical Computing
R Core Team (2000) · doi:10.32614/r.manuals · Cited by 355,706 · see citing works
The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164 · see citing works
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · see citing works
The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00136 · Cited by 10,349 · see citing works
Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., Shibuya, K., Salomon, J. A., Abdalla, S., Aboyans, V., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61729-2 · Cited by 8,291 · see citing works
Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.
Vlaeyen, J. W. S., & Linton, S. J. (2000) · Pain · doi:10.1016/s0304-3959(99)00242-0 · Cited by 4,931 · see citing works
A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability.
Waddell, G., Newton, M., Henderson, I., Somerville, D., & Main, C. J. (1993) · Pain · doi:10.1016/0304-3959(93)90127-b · Cited by 3,167 · see citing works
Chapter 4 European guidelines for the management of chronic nonspecific low back pain
Airaksinen, O., Brox, J. I., Cedraschi, C., Hildebrandt, J., Klaber-Moffett, J., Kovacs, F., Mannion, A. F., Reis, S., Staal, J. B., Ursin, H., et al. (2006) · European Spine Journal · doi:10.1007/s00586-006-1072-1 · Cited by 2,594 · see citing works
Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance
Vlaeyen, J. W. S., Kole-Snijders, A. M. J., Boeren, R. G. B., & van Eek, H. (1995) · Pain · doi:10.1016/0304-3959(94)00279-n · Cited by 2,446 · see citing works
Non-specific low back pain
Balagué, F., Mannion, A. F., Pellisé, F., & Cedraschi, C. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60610-7 · Cited by 1,861 · see citing works
Pain demands attention: A cognitive–affective model of the interruptive function of pain.
Eccleston, C., & Crombez, G. (1999) · Psychological Bulletin · doi:10.1037/0033-2909.125.3.356 · Cited by 1,718 · see citing works
2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group
Furlan, A. D., Pennick, V., Bombardier, C., & van Tulder, M. (2009) · Spine · doi:10.1097/brs.0b013e3181b1c99f · Cited by 1,663 · see citing works
Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability
Crombez, G., Vlaeyen, J. W. S., Heuts, P. H. T. G., & Lysens, R. (1999) · Pain · doi:10.1016/s0304-3959(98)00229-2 · Cited by 1,662 · see citing works
A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain
Pincus, T., Burton, A. K., Vogel, S., & Field, A. P. (2002) · Spine · doi:10.1097/00007632-200203010-00017 · Cited by 1,633 · cited 1× · see citing works
“used treatment strategies is unknown [13-17].”
Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial
Hill, J. C., Whitehurst, D. G., Lewis, M., Bryan, S., Dunn, K. M., Foster, N. E., Konstantinou, K., Main, C. J., Mason, E., Somerville, S., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60937-9 · Cited by 1,306 · see citing works
Fear-avoidance model of chronic musculoskeletal pain: 12 years on
Vlaeyen, J. W. S., & Linton, S. J. (2012) · Pain · doi:10.1016/j.pain.2011.12.009 · Cited by 1,281 · see citing works
Chapter 3 European guidelines for the management of acute nonspecific low back pain in primary care
van Tulder, M., Becker, A., Bekkering, T., Breen, A., del Real, M. T. G., Hutchinson, A., Koes, B., Laerum, E., Malmivaara, A., & On behalf of the COST B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care (2006) · European Spine Journal · doi:10.1007/s00586-006-1071-2 · Cited by 1,258 · see citing works
Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline
Chou, R., & Huffman, L. H. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-7-200710020-00007 · Cited by 1,045 · see citing works
Fear-Avoidance Model of Chronic Pain: The Next Generation
Crombez, G., Eccleston, C., Van Damme, S., Vlaeyen, J. W. S., & Karoly, P. (2012) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e3182385392 · Cited by 960 · see citing works
Impact of psychological factors in the experience of pain
Linton, S. J., & Shaw, W. S. (2011) · Physical Therapy · doi:10.2522/ptj.20100330 · Cited by 819 · see citing works
Psychological approaches to pain management: A practitioner's handbook
Williams, A. C. D. C. (1997) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(96)00324-8 · Cited by 755 · see citing works
The role of fear of movement/(re)injury in pain disability
Vlaeyen, J. W. S., Kole-Snijders, A. M. J., Rotteveel, A. M., Ruesink, R., & Heuts, P. H. T. G. (1995) · Journal of Occupational Rehabilitation · doi:10.1007/bf02109988 · Cited by 730 · see citing works
Low back pain (non-specific)
Krismer, M., & van Tulder, M. (2007) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2006.08.004 · Cited by 694 · see citing works
Early identification and management of psychological risk factors (“Yellow Flags”) in patients with low back pain: a reappraisal
Nicholas, M. K., Linton, S. J., Watson, P. J., & Main, C. J. (2011) · Physical Therapy · doi:10.2522/ptj.20100224 · Cited by 690 · see citing works
Can We Screen for Problematic Back Pain? A Screening Questionnaire for Predicting Outcome in Acute and Subacute Back Pain
Linton, S. J., & HALLDÉN, K. (1998) · Clinical Journal of Pain · doi:10.1097/00002508-199809000-00007 · Cited by 627 · see citing works
Information and advice to patients with back pain can have a positive effect. A randomized controlled trial of a novel educational booklet in primary care.
Burton, A., Waddell, G., Tillotson, K., & Summerton, N. (1999) · Spine · doi:10.1097/00007632-199912010-00010 · Cited by 622 · see citing works
Psychometric properties of the Tampa Scale for kinesiophobia and the fear-avoidance beliefs questionnaire in acute low back pain
Swinkels-Meewisse, E. J. C. M., Swinkels, R. A. H. M., Verbeek, A. L. M., Vlaeyen, J. W. S., & Oostendorp, R. A. B. (2003) · Manual Therapy · doi:10.1054/math.2002.0484 · Cited by 530 · see citing works
A Treatment-Based Classification Approach to Low Back Syndrome: Identifying and Staging Patients for Conservative Treatment
Delitto, A., Erhard, R. E., & Bowling, R. W. (1995) · Physical Therapy · doi:10.1093/ptj/75.6.470 · Cited by 514 · see citing works
The role of fear avoidance beliefs as a prognostic factor for outcome in patients with nonspecific low back pain: A systematic review
Wertli, M. M., Rasmussen-Barr, E., Weiser, S., Bachmann, L. M., & Brunner, F. (2014) · The Spine Journal · doi:10.1016/j.spinee.2013.09.036 · Cited by 479 · see citing works
Self-citation
The Tampa Scale for Kinesiophobia: further examination of psychometric properties in patients with chronic low back pain and fibromyalgia
Roelofs, J., Goubert, L., Peters, M. L., Vlaeyen, J. W. S., & Crombez, G. (2004) · European Journal of Pain · doi:10.1016/j.ejpain.2003.11.016 · Cited by 472 · cited 1× · see citing works
“Further 12 research found that a two factor model based on 13 items to explain up to 70% of the variation and 13 its validity was confirmed [25].”
Background
Graded exposure in vivo in the treatment of pain-related fear: A replicated single-case experimental design in four patients with chronic low back pain
Vlaeyen, J. W. S., de Jong, J., Geilen, M., Heuts, P. H. T. G., & van Breukelen, G. (2001) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00174-6 · Cited by 469 · see citing works
1999 Volvo Award Winner in Clinical Studies
Mannion, A. F., Müntener, M., TAIMELA, S. P., & Dvořák, J. (1999) · Spine · doi:10.1097/00007632-199912010-00004 · Cited by 331 · see citing works
Fear-avoidance and endurance-related responses to pain: new models of behavior and their consequences for clinical practice
Hasenbring, M. I., & Verbunt, J. A. (2010) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e3181e104f2 · Cited by 327 · see citing works
The Effect of a Fear-Avoidance–Based Physical Therapy Intervention for Patients With Acute Low Back Pain: Results of a Randomized Clinical Trial
George, S., Fritz, J., Bialosky, J., & Donald, D. A. (2003) · Spine · doi:10.1097/01.brs.0000096677.84605.a2 · Cited by 299 · see citing works
Identifying Psychosocial Variables in Patients With Acute Work-Related Low Back Pain: The Importance of Fear-Avoidance Beliefs
Fritz, J. M., & George, S. Z. (2002) · Physical Therapy · doi:10.1093/ptj/82.10.973 · Cited by 299 · see citing works
Psychological Approaches to Pain Management
Befner, B. A. (1997) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/0279-3695-19971201-23 · Cited by 299 · see citing works
Evaluating the efficacy of graded in vivo exposure for the treatment of fear in patients with chronic back pain: A randomized controlled clinical trial
Woods, M. P., & Asmundson, G. J. G. (2008) · Pain · doi:10.1016/j.pain.2007.06.037 · Cited by 280 · see citing works
Fear avoidance and prognosis in back pain: A systematic review and synthesis of current evidence
Pincus, T., Vogel, S. K., Burton, K. A., Santos, R., & Field, A. P. (2006) · Arthritis & Rheumatism · doi:10.1002/art.22273 · Cited by 259 · see citing works
Fear of Movement/(Re)injury in Chronic Low Back Pain
de Jong, J. R., Vlaeyen, J. W. S., Onghena, P., Goossens, M. E. J. B., Geilen, M., & Mulder, H. (2004) · Clinical Journal of Pain · doi:10.1097/00002508-200501000-00002 · Cited by 243 · see citing works
What is the prognosis of back pain?
Hayden, J. A., Dunn, K. M., van der Windt, D., & Shaw, W. S. (2010) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2009.12.005 · Cited by 220 · see citing works
Exploration of Physicians’ Recommendations for Activities in Chronic Low Back Pain
Rainville, J., Carlson, N. L., Polatin, P., Gatchel, R., & Indahl, A. (2000) · Spine · doi:10.1097/00007632-200009010-00012 · Cited by 214 · see citing works
Fear-avoidance beliefs and pain avoidance in low back pain--translating research into clinical practice.
Rainville, J., Smeets, R., Bendix, T., Tveito, T., Poiraudeau, S., & Indahl, A. (2011) · The spine journal · doi:10.1016/j.spinee.2011.08.006 · Cited by 209 · see citing works
The Fear Avoidance Model Disentangled: Improving the Clinical Utility of the Fear Avoidance Model
Pincus, T., Smeets, R., Simmonds, M. J., & Sullivan, M. J. L. (2010) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e3181f15d45 · Cited by 201 · see citing works
Psychosocial Influences on Low Back Pain, Disability, and Response to Treatment
Hill, J. C., & Fritz, J. M. (2011) · Physical Therapy · doi:10.2522/ptj.20100280 · Cited by 191 · see citing works
Chronic Low Back Pain
Fourney, D. R., V, Andersson, G. B. J., Arnold, P. M., Dettori, J. R., Cahana, A., Fehlings, M. G., Norvell, D., Samartzis, D., & Chapman, J. R. (2011) · Spine · doi:10.1097/brs.0b013e31822f0a0d · Cited by 175 · see citing works
Methodological criteria for the assessment of moderators in systematic reviews of randomised controlled trials: a consensus study.
Pincus, T., Miles, C., Froud, R., Underwood, M., Carnes, D., & Taylor, S. J. (2011) · BMC Medical Research Methodology · doi:10.1186/1471-2288-11-14 · Cited by 161 · see citing works
Systematic review of back schools, brief education, and fear-avoidance training for chronic low back pain
Brox, J. I., Storheim, K., Grotle, M., Tveito, T. H., Indahl, A., & Eriksen, H. R. (2007) · The Spine Journal · doi:10.1016/j.spinee.2007.07.389 · Cited by 148 · see citing works
Motor control problems in patients with spinal pain: a new direction for therapeutic exercise
Jull, G. A., & Richardson, C. A. (2000) · Journal of Manipulative and Physiological Therapeutics · doi:10.1016/s0161-4754(00)90079-4 · Cited by 145 · see citing works
High Fear-Avoiders of Physical Activity Benefit From an Exercise Program for Patients With Back Pain
Moffett, J. K. K., Carr, J., & Howarth, E. (2004) · Spine · doi:10.1097/00007632-200406010-00002 · Cited by 144 · see citing works
A randomized trial of behavioral physical therapy interventions for acute and sub-acute low back pain (NCT00373867)
George, S. Z., Zeppieri, G., Cere, A. L., Cere, M. R., Borut, M. S., Hodges, M. J., Reed, D. M., Valencia, C., & Robinson, M. E. (2008) · Pain · doi:10.1016/j.pain.2008.07.029 · Cited by 134 · see citing works
Neck pain
Jensen, I. B., & Harms‐Ringdahl, K. (2007) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2006.10.003 · Cited by 125 · see citing works
A review and proposal for a core set of factors for prospective cohorts in low back pain: A consensus statement
Pincus, T., Santos, R., Breen, A., Burton, A. K., & Underwood, M. (2008) · Arthritis Care & Research · doi:10.1002/art.23251 · Cited by 123 · see citing works
Doctors With a Special Interest in Back Pain Have Poorer Knowledge About How to Treat Back Pain
Buchbinder, R., Staples, M., & Jolley, D. (2009) · Spine · doi:10.1097/brs.0b013e318195d688 · Cited by 117 · see citing works
Fear-Avoidance Beliefs, Catastrophizing, and Distress
Westman, A., Boersma, K., Leppert, J., & Linton, S. J. (2011) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e318219ab6c · Cited by 94 · see citing works
Predictors of return to work in patients sick listed for sub-acute low back pain: a 12-month follow-up study
Storheim, K., Brox, J. I., Holm, I., & Bø, K. (2005) · Journal of Rehabilitation Medicine · doi:10.1080/16501970510040344 · Cited by 83 · see citing works
Can rate of recovery be predicted in patients with acute low back pain? Development of a clinical prediction rule
Hancock, M. J., Maher, C. G., Latimer, J., Herbert, R., & McAuley, J. H. (2008) · European Journal of Pain · doi:10.1016/j.ejpain.2008.03.007 · Cited by 83 · see citing works
Predictors of Pain Outcomes in Patients with Chronic Musculoskeletal Pain Co-morbid with Depression: Results from a Randomized Controlled Trial
Ang, D. C., Bair, M. J., Damush, T. M., Wu, J., Tu, W., & Kroenke, K. (2010) · Pain Medicine · doi:10.1111/j.1526-4637.2009.00759.x · Cited by 72 · see citing works
Predictors of Outcome in Patients With (Sub)Acute Low Back Pain Differ Across Treatment Groups
Jellema, P., van der Horst, H. E., Vlaeyen, J. W. S., Stalman, W. A. B., Bouter, L. M., & van der Windt, D. (2006) · Spine · doi:10.1097/01.brs.0000224179.04964.aa · Cited by 71 · see citing works
Graded exposure in vivo for pain-related fear
Vlaeyen, J. W. S., de Jong, J. R., Sieben, J. M., & Crombez, G. (2002) · Ghent University Academic Bibliography (Ghent University) · doi:10.1201/b13472 · Cited by 69 · see citing works
Physiotherapy‐provided operant conditioning in the management of low back pain disability: A systematic review
Bunzli, S., Gillham, D., & Esterman, A. (2011) · Physiotherapy Research International · doi:10.1002/pri.465 · Cited by 61 · see citing works
Multidisciplinary Rehabilitation Treatment of Patients With Chronic Low Back Pain: A Prognostic Model for Its Outcome
van der Hulst, M., Vollenbroek-Hutten, M. M. R., Groothuis‐Oudshoorn, C. G. M., & Hermens, H. J. (2008) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31816719f5 · Cited by 56 · see citing works
Scottish Intercollegiate Guidelines Network: the first 15 years (1993–2008)
Harbour, R., Lowe, G., & Twaddle, S. (2011) · The Journal of the Royal College of Physicians of Edinburgh · doi:10.4997/jrcpe.2011.209 · Cited by 54 · see citing works
Low Back Pain Subgroups Using Fear-Avoidance Model Measures
Beneciuk, J. M., Robinson, M. E., & George, S. Z. (2012) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31824306ed · Cited by 51 · see citing works
Graded activity for workers with low back pain: Who benefits most and how does it work?
Staal, J. B., Hlobil, H., Köke, A. J. A., Twisk, J. W. R., Smid, T., & van Mechelen, W. (2008) · Arthritis Care & Research · doi:10.1002/art.23570 · Cited by 48 · see citing works
Motivating disability pensioners with back pain to return to work - a randomized controlled trial
Magnussen, L., Strand, L., Skouen, J. S., & Eriksen, H. (2007) · Acta Dermato Venereologica · doi:10.2340/16501977-0004 · Cited by 43 · see citing works
Identifying Patient Fear-Avoidance Beliefs by Physical Therapists Managing Patients With Low Back Pain
Calley, D. Q., Jackson, S., Collins, H. R., & George, S. Z. (2010) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2010.3381 · Cited by 42 · see citing works
Assessing pain and pain-related fear in acute low back pain: what is the smallest detectable change?
Ostelo, R., Swinkels-Meewisse, I., Vlaeyen, J. W. S., Knol, D. L., & de Vet, H. C. W. (2007) · International Journal of Behavioral Medicine · doi:10.1007/bf03002999 · Cited by 42 · see citing works
Sex Differences in Predictors of Outcome in Selected Physical Therapy Interventions for Acute Low Back Pain
George, S. Z., Fritz, J. M., Childs, J. D., & Brennan, G. P. (2006) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2006.2270 · Cited by 35 · see citing works
Factors predicting clinical outcome 12 and 36 months after an exercise intervention for recurrent low-back pain
Rasmussen-Barr, E., Campello, M. A., Arvidsson, I., Nilsson-Wikmar, L. B., & Äng, B. O. (2011) · Disability and Rehabilitation · doi:10.3109/09638288.2011.591886 · Cited by 26 · see citing works
Self-citation
Can Predictors of Response to NSAIDs Be Identified in Patients With Acute Low Back Pain?
Hancock, M. J., Maher, C. G., Latimer, J., McLachlan, A. J., Day, R. O., & Davies, R. A. (2009) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e3181a7ee3a · Cited by 26 · see citing works
Physicians’ Determinants for Sick-listing LBP Patients
Werner, E. L., Côté, P., Fullen, B. M., & Hayden, J. A. (2011) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31822cf64f · Cited by 24 · see citing works
Predicting response to a cognitive-behavioral approach to treating low back pain: Secondary analysis of the BeST data set
Underwood, M., Mistry, D., Lall, R., & Lamb, S. (2011) · Arthritis Care & Research · doi:10.1002/acr.20518 · Cited by 23 · see citing works
Incomplete Reporting of Baseline Characteristics in Clinical Trials: An Analysis of Randomized Controlled Trials and Systematic Reviews Involving Patients with Chronic Low Back Pain
Wertli, M. M., Schöb, M., Brunner, F., & Steurer, J. (2013) · PLoS ONE · doi:10.1371/journal.pone.0058512 · Cited by 15 · see citing works
Self-citation
Fear avoidance beliefs and low back pain: “practical reviews” from expert panel discussions versus comprehensive systematic reviews
Kovacs, F. M., Abraira, V., Queraltó, J. M., Albaladejo, C., Zamora, J., Royuela, A., Muriel, A., Gestoso, M., & Mufraggi, N. (2012) · The Spine Journal · doi:10.1016/j.spinee.2012.01.002 · Cited by 6 · see citing works
Letters
Vemmer, T. (2009) · Spine · doi:10.1097/brs.0b013e3181b44360 · Cited by 6 · see citing works

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Edwards, R. R., Dworkin, R. H., Sullivan, M. D., Turk, D. C., & Wasan, A. D. (2016) · The Journal of Pain · doi:10.1016/j.jpain.2016.01.001 · Cited by 954 · see citing works
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Owen, P. J., Miller, C. T., Mundell, N. L., Verswijveren, S. J. J. M., Tagliaferri, S. D., Brisby, H., Bowe, S. J., & Belavý, D. L. (2019) · British Journal of Sports Medicine · doi:10.1136/bjsports-2019-100886 · Cited by 562 · see citing works
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Luque-Suarez, A., Martinez-Calderon, J., & Falla, D. (2019) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-098673 · Cited by 546 · see citing works
Low back pain
Vlaeyen, J. W. S., Maher, C. G., Wiech, K., Van Zundert, J., Meloto, C. B., Diatchenko, L., Battié, M. C., Goossens, M., Koes, B., & Linton, S. J. (2018) · Nature Reviews Disease Primers · doi:10.1038/s41572-018-0052-1 · Cited by 497 · see citing works
Catastrophizing-a prognostic factor for outcome in patients with low back pain: a systematic review
Wertli, M. M., Eugster, R., Held, U., Steurer, J., Kofmehl, R., & Weiser, S. (2014) · The Spine Journal · doi:10.1016/j.spinee.2014.03.003 · Cited by 363 · see citing works
Self-citation
Fear of Reinjury in Athletes
Hsu, C., Meierbachtol, A., George, S. Z., & Chmielewski, T. L. (2016) · Sports Health A Multidisciplinary Approach · doi:10.1177/1941738116666813 · Cited by 243 · see citing works
Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis
Ho, E. K.-Y., Chen, L., Simic, M., Ashton-James, C. E., Comachio, J., Wang, D. X. M., Hayden, J. A., Ferreira, M. L., & Ferreira, P. H. (2022) · BMJ · doi:10.1136/bmj-2021-067718 · Cited by 220 · see citing works
Pain-related fear, disability, and the fear-avoidance model of chronic pain
Zale, E. L., & Ditre, J. W. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2015.03.014 · Cited by 203 · see citing works
Are Pain Beliefs, Cognitions, and Behaviors Influenced by Race, Ethnicity, and Culture in Patients with Chronic Musculoskeletal Pain: A Systematic Review
Meeus, M. (2018) · Pain Physician · doi:10.36076/ppj.2018.6.541 · Cited by 176 · see citing works
Psychosocial factors associated with change in pain and disability outcomes in chronic low back pain patients treated by physiotherapist: A systematic review
Alhowimel, A., AlOtaibi, M., Radford, K., & Coulson, N. (2018) · SAGE Open Medicine · doi:10.1177/2050312118757387 · Cited by 144 · see citing works
Pain-Related Fear, Pain Intensity and Function in Individuals With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis
Martinez-Calderon, J., Flores-Cortes, M., Morales-Asencio, J. M., & Luque-Suarez, A. (2019) · The Journal of Pain · doi:10.1016/j.jpain.2019.04.009 · Cited by 141 · see citing works
Evaluation of Cognitive Behavioral Therapy on Improving Pain, Fear Avoidance, and Self-Efficacy in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis
Yang, J., Lo, W. L. A., Zheng, F., Cheng, X., Yu, Q., & Wang, C. (2022) · Pain Research and Management · doi:10.1155/2022/4276175 · Cited by 121 · see citing works
The association between pain beliefs and pain intensity and/or disability in people with shoulder pain: A systematic review
Martínez-Calderón, J., Struyf, F., Meeus, M., & Luque-Suárez, A. (2018) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2018.06.010 · Cited by 113 · see citing works
Association of psychological variables and outcome in tendinopathy: a systematic review
Mallows, A. J., Debenham, J. R., Walker, T., & Littlewood, C. (2016) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096154 · Cited by 108 · see citing works
Pain interference and physical function demonstrate poor longitudinal association in people living with pain: a PROMIS investigation
Karayannis, N. V., Sturgeon, J. A., Chih-Kao, M., Cooley, C., & Mackey, S. (2017) · Pain · doi:10.1097/j.pain.0000000000000881 · Cited by 108 · see citing works
Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial
Yilmaz Yelvar, G. D., Çırak, Y., Dalkılınç, M., Parlak Demir, Y., Guner, Z., & Boydak, A. (2017) · European Spine Journal · doi:10.1007/s00586-016-4892-7 · Cited by 107 · see citing works
Feasibility and Safety of a Virtual Reality Dodgeball Intervention for Chronic Low Back Pain: A Randomized Clinical Trial
Thomas, J. S., France, C. R., Applegate, M. E., Leitkam, S. T., & Walkowski, S. (2016) · The Journal of Pain · doi:10.1016/j.jpain.2016.08.011 · Cited by 107 · see citing works
Exercise and Chronic Pain
Borisovskaya, A., Chmelik, E., & Karnik, A. (2020) · Advances in Experimental Medicine and Biology · doi:10.1007/978-981-15-1792-1_16 · Cited by 102 · see citing works
Central sensitization and the biopsychosocial approach to understanding pain
Adams, L. M., & Turk, D. C. (2018) · Journal of Applied Biobehavioral Research · doi:10.1111/jabr.12125 · Cited by 99 · see citing works
Lumbar range of motion in chronic low back pain is predicted by task‐specific, but not by general measures of pain‐related fear
Matheve, T., Baets, L. D., Bogaerts, K., & Timmermans, A. A. A. (2019) · European Journal of Pain · doi:10.1002/ejp.1384 · Cited by 93 · see citing works
Relationship between psychological factors and spinal motor behaviour in low back pain: a systematic review and meta-analysis
Christe, G., Crombez, G., Edd, S., Opsommer, E., Jolles, B. M., & Favre, J. (2020) · Pain · doi:10.1097/j.pain.0000000000002065 · Cited by 96 · see citing works
Clinician and Patient-reported Outcomes Are Associated With Psychological Factors in Patients With Chronic Shoulder Pain
Wolfensberger, A., Vuistiner, P., Konzelmann, M., Plomb-Holmes, C., Léger, B., & Lüthi, F. (2016) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-016-4894-0 · Cited by 88 · see citing works
How do psychologically based interventions for chronic musculoskeletal pain work? A systematic review and meta-analysis of specific moderators and mediators of treatment
Murillo, C., Vo, T., Vansteelandt, S., Harrison, L. E., Cagnie, B. J., Coppieters, I., Chys, M., Timmers, I., & Meeus, M. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2022.102160 · Cited by 85 · see citing works
Biopsychosocial factors associated with chronic low back pain disability in rural Nigeria: a population-based cross-sectional study
Igwesi-Chidobe, C. N., Coker, B., Onwasigwe, C. N., Sorinola, I. O., & Godfrey, E. L. (2017) · BMJ Global Health · doi:10.1136/bmjgh-2017-000284 · Cited by 81 · see citing works
GLA:D® Back group-based patient education integrated with exercises to support self-management of back pain - development, theories and scientific evidence -
Kjær, P., Kongsted, A., Ris, I., Abbott, A. D., Rasmussen, C. D. N., Roos, E. M., Skou, S. T., Andersen, T. E., & Hartvigsen, J. (2018) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-018-2334-x · Cited by 76 · see citing works
The Impact of Depression on Patient Outcomes in Hip Arthroscopic Surgery
Martin, R. L., Christoforetti, J. J., McGovern, R. P., Kivlan, B. R., Wolff, A. B., Nho, S. J., Salvo, J. P., Ellis, T. J., Thiel, G. V., Matsuda, D. K., et al. (2018) · Orthopaedic Journal of Sports Medicine · doi:10.1177/2325967118806490 · Cited by 76 · see citing works
The Fear‐avoidance Components Scale ( FACS ): Development and Psychometric Evaluation of a New Measure of Pain‐related Fear Avoidance
Neblett, R., Mayer, T. G., Hartzell, M. M., Williams, M. J., & Gatchel, R. J. (2015) · Pain Practice · doi:10.1111/papr.12333 · Cited by 70 · see citing works
A Decision Support System to Enhance Self-Management of Low Back Pain: Protocol for the selfBACK Project
Mork, P. J., & Bach, K. (2018) · JMIR Research Protocols · doi:10.2196/resprot.9379 · Cited by 64 · see citing works
Multisystem Resiliency as a Predictor of Physical and Psychological Functioning in Older Adults With Chronic Low Back Pain
Bartley, E. J., Palit, S., Fillingim, R. B., & Robinson, M. E. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01932 · Cited by 64 · see citing works
Unhelpful beliefs and attitudes about low back pain in the general population: A cross-sectional survey
Christe, G., Pizzolato, V., Meyer, M., Nzamba, J., & Pichonnaz, C. (2021) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2021.102342 · Cited by 58 · see citing works
Development of the Return-to-Work Obstacles and Self-Efficacy Scale (ROSES) and Validation with Workers Suffering from a Common Mental Disorder or Musculoskeletal Disorder
Corbière, M., Negrini, A., Durand, M., St-Arnaud, L., Briand, C., Fassier, J., Loisel, P., & Lachance, J.-P. (2016) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-016-9661-2 · Cited by 58 · see citing works
Conservative Interventions Reduce Fear in Individuals With Chronic Low Back Pain: A Systematic Review
Martínez-Calderón, J., Flores-Cortés, M., Morales‐Asencio, J. M., & Luque-Suárez, A. (2019) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2019.08.470 · Cited by 55 · see citing works
A Qualitative Study of Veterans on Long-Term Opioid Analgesics: Barriers and Facilitators to Multimodality Pain Management
Simmonds, M. J., Finley, E. P., Arismendez, S. V., Pugh, M. J., & Turner, B. J. (2014) · Pain Medicine · doi:10.1111/pme.12626 · Cited by 55 · see citing works
Use of Pain Neuroscience Education, Tactile Discrimination, and Graded Motor Imagery in an Individual With Frozen Shoulder
Sawyer, E. E., McDevitt, A. W., Louw, A., Puentedura, E. J., & Mintken, P. E. (2017) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2018.7716 · Cited by 55 · see citing works
Effects of pre-surgery physiotherapy on walking ability and lower extremity strength in patients with degenerative lumbar spine disorder: Secondary outcomes of the PREPARE randomised controlled trial
Fors, M., Enthoven, P., Abbott, A. D., & Öberg, B. E. (2019) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-019-2850-3 · Cited by 56 · see citing works
Quality and Usability of Arthritic Pain Self-Management Apps for Older Adults: A Systematic Review
Vandersman, P., Newton-John, T. R. O., & Phillips, J. L. (2017) · Pain Medicine · doi:10.1093/pm/pnx090 · Cited by 52 · see citing works
Decoding pain chronification: mechanisms of the acute-to-chronic transition
Zhang, S., Ning, Y., Yang, Y., Mu, G., Yang, Y., Ren, C., Liao, C., Ou, C., & Zhang, Y. (2025) · Frontiers in Molecular Neuroscience · doi:10.3389/fnmol.2025.1596367 · Cited by 60 · see citing works
Individualised cognitive functional therapy compared with a combined exercise and pain education class for patients with non-specific chronic low back pain: study protocol for a multicentre randomised controlled trial
O’Keeffe, M., Purtill, H., Kennedy, N., O’Sullivan, P., Dankaerts, W., Tighe, A., Allworthy, L., Dolan, L., Bargary, N., & O’Sullivan, K. (2015) · BMJ Open · doi:10.1136/bmjopen-2014-007156 · Cited by 53 · see citing works
Clinical assessment and patient-reported outcome measures in low-back pain – a survey among primary health care physiotherapists
Östhols, S., Boström, C., & Rasmussen-Barr, E. (2018) · Disability and Rehabilitation · doi:10.1080/09638288.2018.1467503 · Cited by 52 · see citing works
Self-citation
Timing of anterior cruciate ligament reconstruction and preoperative pain are important predictors for postoperative kinesiophobia
Theunissen, W. W. E. S., van der Steen, M. C., Liu, W.-Y., & Janssen, R. P. A. (2019) · Knee Surgery Sports Traumatology Arthroscopy · doi:10.1007/s00167-019-05838-z · Cited by 52 · see citing works
Predictors of functional outcome in musculoskeletal healthcare: An umbrella review
Burgess, R., Mansell, G., Bishop, A., Lewis, M., & Hill, J. C. (2019) · European Journal of Pain · doi:10.1002/ejp.1483 · Cited by 50 · see citing works
Antioxidant and hepatoprotective activity of tubers of Momordica tuberosa Cogn. against CCl4 induced liver injury in rats.
Kumar, P., Deval, R. G., Lakshmayya, L., & Ramachandra, S. S. (2008) · PubMed · Cited by 50 · see citing works
Reliability, responsiveness and minimal clinically important difference of the two Fear Avoidance and Beliefs Questionnaire scales in Italian subjects with chronic low back pain undergoing multidisciplinary rehabilitation
Monticone, M., Frigau, L., Vernon, H. T., Rocca, B., Giordano, A., Vullo, S. S., Molà, F., & Franchignoni, F. P. (2020) · European Journal of Physical and Rehabilitation Medicine · doi:10.23736/s1973-9087.20.06158-4 · Cited by 47 · see citing works
Do psychological factors affect outcomes in musculoskeletal shoulder disorders? A systematic review
Sheikhzadeh, A., Wertli, M. M., Weiner, S. S., Rasmussen-Barr, E., & Weiser, S. R. (2021) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-021-04359-6 · Cited by 47 · see citing works
Self-citation
Obesity is associated with more disability at presentation and after treatment in low back pain but not in neck pain: findings from the OIOC registry
Wertli, M. M., Held, U., Campello, M. A., & Weiner, S. S. (2016) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-016-0992-0 · Cited by 43 · see citing works
Self-citation
Change in pain, disability and influence of fear-avoidance in a work-focused intervention on neck and back pain: a randomized controlled trial
Marchand, G. H., Myhre, K., Leivseth, G., Sandvik, L., Lau, B., Bautz-Holter, E., & Røe, C. (2015) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-015-0553-y · Cited by 41 · see citing works
Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Biobehavioural Synchrony in Musculoskeletal Care
McParlin, Z., Cerritelli, F., Rossettini, G., Friston, K. J., & Esteves, J. E. (2022) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2022.897247 · Cited by 42 · see citing works
Influence of Baseline Kinesiophobia Levels on Treatment Outcome in People With Chronic Spinal Pain
Bogaert, W. V., Coppieters, I., Kregel, J., Nijs, J., Pauw, R. D., Meeus, M., Cagnie, B. J., Danneels, L. A., & Malfliet, A. (2021) · Physical Therapy · doi:10.1093/ptj/pzab076 · Cited by 41 · see citing works
The effect of motor control and tactile acuity training on patients with non-specific low back pain and movement control impairment
Gutknecht, M., Mannig, A., Waldvogel, A., Wand, B. M., & Luomajoki, H. A. (2015) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2014.12.003 · Cited by 40 · see citing works
Pain resilience moderates the influence of negative pain beliefs on movement-evoked pain in older adults
Palit, S., Fillingim, R. B., & Bartley, E. J. (2019) · Journal of Behavioral Medicine · doi:10.1007/s10865-019-00110-8 · Cited by 41 · see citing works
Physical therapy clinical specialization and management of red and yellow flags in patients with low back pain in the United States
Ladeira, C. (2018) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2017.1390652 · Cited by 39 · see citing works
The use of pain neuroscience education in older adults with chronic back and/or lower extremity pain
Rufa, A., Beissner, K., & Dolphin, M. (2018) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2018.1456586 · Cited by 40 · see citing works
Experiences and attitudes about physical activity and exercise in patients with chronic pain: a qualitative interview study
Karlsson, L., Gerdle, B. U. C., Takala, E., Andersson, G., & Larsson, B. K. (2018) · Journal of Pain Research · doi:10.2147/jpr.s149826 · Cited by 39 · see citing works
The importance of emotional distress, cognitive behavioural factors and pain for life impact at baseline and for outcomes after rehabilitation – a SQRP study of more than 20,000 chronic pain patients
Gerdle, B. U. C., Åkerblom, S., Stålnacke, B., Jansen, G. B., Enthoven, P., Ernberg, M. M., Dong, H., Äng, B. O., & Boersma, K. (2019) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2019-0016 · Cited by 36 · see citing works
Predictors of Pain, Function, and Change in Patellofemoral Pain
Hott, A., Brox, J., Pripp, A., Juel, N., & Liavaag, S. (2019) · American Journal of Sports Medicine · doi:10.1177/0363546519889623 · Cited by 27 · see citing works
Biopsychosocial risk factors associated with chronic low back pain after lower limb amputation
Farrokhi, S., Mazzone, B. N., Schneider, M., Gombatto, S. P., Mayer, J. M., Highsmith, M. J., & Hendershot, B. D. (2017) · Medical Hypotheses · doi:10.1016/j.mehy.2017.07.030 · Cited by 36 · see citing works
Virtual Reality as a Therapy Adjunct for Fear of Movement in Veterans With Chronic Pain: Single-Arm Feasibility Study
Fowler, C. A., Ballistrea, L. M., Mazzone, K. E., Martin, A. M., Kaplan, H., Kip, K. E., Ralston, K., Murphy, J. L., & Winkler, S. L. (2019) · JMIR Formative Research · doi:10.2196/11266 · Cited by 36 · see citing works
Self‐efficacy as a prognostic factor and treatment moderator in chronic musculoskeletal pain patients attending pain management programmes: A systematic review
Hayward, R., & Stynes, S. M. (2020) · Musculoskeletal Care · doi:10.1002/msc.1533 · Cited by 36 · see citing works
Optimism Moderates the Influence of Pain Catastrophizing on Shoulder Pain Outcome: A Longitudinal Analysis
Coronado, R. A., Simon, C. B., Lentz, T. A., Gay, C. W., Mackie, L. N., & George, S. Z. (2016) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2017.7068 · Cited by 35 · see citing works
Six Weeks Effects of Dynamic Neuromuscular Stabilization (DNS) Training in Obese Postpartum Women With Low Back Pain: A Randomized Controlled Trial
Ghavipanje, V., Rahimi, N. M., & Akhlaghi, F. (2021) · Biological Research For Nursing · doi:10.1177/10998004211044828 · Cited by 38 · see citing works
Are Changes in Fear-Avoidance Beliefs and Self-efficacy Mediators of Function and Pain at Discharge in Patients With Acute and Chronic Low Back Pain?
Riley, S. P., Bialosky, J. E., & Coronado, R. A. (2020) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2020.8982 · Cited by 34 · see citing works
Kinesiophobia could affect shoulder function after repair of rotator cuff tears
Wang, H. H., Hu, F., Lyu, X., Jia, H., Wang, B., Liu, F., & Yang, Y. (2022) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-022-05679-x · Cited by 36 · see citing works
The Influence of Pre- and Postoperative Fear Avoidance Beliefs on Postoperative Pain and Disability in Patients With Lumbar Spinal Stenosis
Burgstaller, J. M., Wertli, M. M., Steurer, J., Kessels, A. G. H., Held, U., & Gramke, H. (2016) · Spine · doi:10.1097/brs.0000000000001845 · Cited by 33 · see citing works
Self-citation
Trajectories of Fear‐Avoidance Beliefs on Physical Activity Over Two Years in People With Rheumatoid Arthritis
Demmelmaier, I., Björk, A., Dufour, A. B., Nordgren, B., & Opava, C. H. (2017) · Arthritis Care & Research · doi:10.1002/acr.23419 · Cited by 33 · see citing works
Vulvodynia: a consideration of clinical and methodological research challenges and recommended solutions
Corsini‐Munt, S., Rancourt, K. M., Dubé, J. P., Rossi, M. A., & Rosen, N. O. (2017) · Journal of Pain Research · doi:10.2147/jpr.s126259 · Cited by 33 · see citing works
Both positive and negative beliefs are important in patients with spine pain: findings from the Occupational and Industrial Orthopaedic Center registry.
Wertli, M., Held, U., Lis, A., Campello, M., & Weiser, S. (2017) · The spine journal · doi:10.1016/j.spinee.2017.07.166 · Cited by 24 · see citing works
Self-citation
Unraveling the role of fear and avoidance behavior in chronic musculoskeletal pain: from theory to physical therapy clinical practice
Alaiti, R. K., dos Reis, F. J. J., Sanchez, T. A., Cañeiro, J. P., & Meulders, A. (2025) · Brazilian Journal of Physical Therapy · doi:10.1016/j.bjpt.2025.101197 · Cited by 35 · see citing works
Psychometric validation of the Serbian version of the Fear Avoidance Component Scale (FACS)
Knežević, A., Neblett, R., Gatchel, R. J., Jeremić-Knežević, M., Ignjatović, V. B., Tomašević-Todorović, S., Bošković, K., & Vargas, A. I. C. (2018) · PLoS ONE · doi:10.1371/journal.pone.0204311 · Cited by 31 · see citing works
Should musicians play in pain?
Stanhope, J., & Weinstein, P. (2020) · British Journal of Pain · doi:10.1177/2049463720911399 · Cited by 33 · see citing works
Is the word "osteoporosis" a reason for kinesiophobia?
Günendi, Z., Büyükşireci, D. E., Tecer, D., Karaoğlan, B., & Taşkıran, Ö. Ö. (2018) · European Journal of Physical and Rehabilitation Medicine · doi:10.23736/s1973-9087.18.04931-6 · Cited by 31 · see citing works
Acceptance and commitment therapy for chronic pain: Protocol of a systematic review and individual participant data meta-Analysis
Lin, J., Scott, W., Carpenter, L., Norton, S., Domhardt, M., Baumeister, H., & McCracken, L. M. (2019) · Systematic Reviews · doi:10.1186/s13643-019-1044-2 · Cited by 30 · see citing works
Effects of aerobic exercise in addition to core stabilization exercises on functional capacity, physical performance and fall risk in geriatric individuals with chronic non-specific low back pain
Kuzu, Ş., Canlı, M., Valamur, İ., Özüdoğru, A., Alkan, H., & Hartavi, A. (2025) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-025-01271-7 · Cited by 32 · see citing works
Associations between psychological factors and the effect of home-based physical exercise in women with chronic neck and shoulder pain
Karlsson, L., Gerdle, B. U. C., Takala, E., Andersson, G., & Larsson, B. K. (2016) · SAGE Open Medicine · doi:10.1177/2050312116668933 · Cited by 29 · see citing works
The Back Belief Questionnaire is efficient to assess false beliefs and related fear in low back pain populations: A transcultural adaptation and validation study
Dupeyron, A., Lanhers, C., Bastide, S., Alonso, S., Toulotte, M., Jourdan, C., & Coudeyre, E. (2017) · PLoS ONE · doi:10.1371/journal.pone.0186753 · Cited by 29 · see citing works
Association between depression and anxiety on symptom and function after surgery for lumbar spinal stenosis
Held, U., Burgstaller, J. M., Deforth, M. E., Steurer, J., Pichierri, G., & Wertli, M. M. (2022) · Scientific Reports · doi:10.1038/s41598-022-06797-1 · Cited by 29 · see citing works
Self-citation
Psychometric validation of the cross-culturally adapted traditional Chinese version of the Back Beliefs Questionnaire (BBQ) and Fear-Avoidance Beliefs Questionnaire (FABQ)
Cheung, P. W. H., Wong, C. K. H., & Cheung, J. P. Y. (2018) · European Spine Journal · doi:10.1007/s00586-018-5576-2 · Cited by 28 · see citing works
Low Back Pain–Related Disability Is Associated with Pain-Related Beliefs Across Divergent Non–English-Speaking Populations: Systematic Review and Meta-Analysis
Alamam, D., Leaver, A. M., Alsobayel, H., Moloney, N. A., Lin, J., & Mackey, M. (2020) · Pain Medicine · doi:10.1093/pm/pnaa430 · Cited by 30 · see citing works
Defining the Role of Cognitive Behavioral Therapy in Treating Chronic Low Back Pain: An Overview
Hanscom, D. A., Brox, J. I., & Bunnage, R. (2015) · Global Spine Journal · doi:10.1055/s-0035-1567836 · Cited by 28 · see citing works
Fear-avoidance beliefs increase perception of pain and disability in Mexicans with chronic low back pain
Nava‐Bringas, T. I., Macías‐Hernández, S. I., Vásquez‐Ríos, J. R., Coronado‐Zarco, R., Miranda‐Duarte, A., Cruz‐Medina, E., & Arellano‐Hernández, A. (2016) · Revista Brasileira de Reumatologia (English Edition) · doi:10.1016/j.rbre.2016.11.003 · Cited by 28 · see citing works
Identifying Motor Control Strategies and Their Role in Low Back Pain: A Cross-Disciplinary Approach Bridging Neurosciences With Movement Biomechanics
Schmid, S., Bangerter, C., Schweinhardt, P., & Meier, M. L. (2021) · Frontiers in Pain Research · doi:10.3389/fpain.2021.715219 · Cited by 29 · see citing works
Longitudinal associations of kinematics and fear-avoidance beliefs with disability, work ability and pain intensity in persons with low back pain
Nordstoga, A. L., Meisingset, I., Vasseljen, O., Nilsen, T. I. L., & Unsgaard‐Tøndel, M. (2019) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2019.03.008 · Cited by 27 · see citing works
Reduction in sick leave by a workplace educational low back pain intervention: A cluster randomized controlled trial
Ree, E., Lie, S. A., Eriksen, H. R., Malterud, K., Indahl, A., Samdal, O., & Harris, A. (2016) · Scandinavian Journal of Public Health · doi:10.1177/1403494816653854 · Cited by 26 · see citing works
Psychological interventions for reducing fear avoidance beliefs among people with chronic back pain.
Vergeld, V., Ginis, K. A. M., & Jenks, A. D. (2021) · Rehabilitation Psychology · doi:10.1037/rep0000394 · Cited by 25 · see citing works
The Cognitive and Behavioural Responses to Symptoms Questionnaire (CBRQ): Development, reliability and validity across several long‐term conditions
Picariello, F., Chilcot, J., Chalder, T., Herdman, D., & Moss-Morris, R. E. (2023) · British Journal of Health Psychology · doi:10.1111/bjhp.12644 · Cited by 26 · see citing works
The Fear-Avoidance Components Scale (FACS)
Neblett, R., Mayer, T. G., Williams, M. J., Asih, S. R., Vargas, A. I. C., Hartzell, M. M., & Gatchel, R. J. (2017) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000501 · Cited by 25 · see citing works
Psychological Factors Associated With Painful Versus Non-Painful HIV-Associated Sensory Neuropathy
Pillay, P., Wadley, A. L., Cherry, C. L., Karstaedt, A., & Kamerman, P. R. (2017) · AIDS and Behavior · doi:10.1007/s10461-017-1856-9 · Cited by 25 · see citing works
Improvements in clinical pain and experimental pain sensitivity after cognitive functional therapy in patients with severe persistent low back pain
Vægter, H. B., Ussing, K., Johansen, J. V., Stegemejer, I., Palsson, T. S., O’Sullivan, P., & Kent, P. M. (2019) · PAIN Reports · doi:10.1097/pr9.0000000000000802 · Cited by 25 · see citing works
Reference Values of the Pain Disability Index in Patients With Painful Musculoskeletal and Spinal Disorders
Soer, R., Köke, A. J. A., Speijer, B. L. G. N., Vroomen, P. C. A. J., Smeets, R., Coppes, M. H., Reneman, M. F., & Gross, D. P. (2015) · Spine · doi:10.1097/brs.0000000000000827 · Cited by 25 · see citing works
Pain-Related Fear—Dissociable Neural Sources of Different Fear Constructs
Meier, M. L., Vrana, A., Humphreys, B. K., Seifritz, E., Stämpfli, P., & Schweinhardt, P. (2018) · eNeuro · doi:10.1523/eneuro.0107-18.2018 · Cited by 25 · see citing works
Which Chronic Low Back Pain Patients Respond Favorably to Yoga, Physical Therapy, and a Self-care Book? Responder Analyses from a Randomized Controlled Trial
Roseen, E. J., Gerlovin, H., Felson, D. T., Delitto, A., Sherman, K. J., & Saper, R. B. (2020) · Pain Medicine · doi:10.1093/pm/pnaa153 · Cited by 25 · see citing works
Neuromuscular exercise and back counselling for female nursing personnel with recurrent non-specific low back pain: study protocol of a randomised controlled trial (NURSE-RCT)
Suni, J. H., Rinne, M. B., Kankaanpaa, M. J., Taulaniemi, A., Lusa, S., Lindholm, H. J., & Parkkari, J. P. (2016) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2015-000098 · Cited by 24 · see citing works
Changing beliefs for changing movement and pain: Classification-based cognitive functional therapy (CB–CFT) for chronic non-specific low back pain
Meziat‐Filho, N. (2015) · Manual Therapy · doi:10.1016/j.math.2015.04.013 · Cited by 23 · see citing works
Physical clinical care and artificial-intelligence-guided core resistance training improve endurance and patient-reported outcomes in subjects with lower back pain
Bates, N. A., Huffman, A., Goodyear, E. G., Nagai, T., Rigamonti, L., Breuer, L., Holmes, B. D., & Schilaty, N. D. (2023) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2023.105902 · Cited by 23 · see citing works
Deconstructing Chronic Low Back Pain in the Older Adult – Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment. Part V: Maladaptive Coping
DiNapoli, E. A., Craine, M. H., Dougherty, P. E., Gentili, A., Kochersberger, G. G., Morone, N. E., Murphy, J. L., Rodakowski, J. L., Rodríguez, E., Thielke, S. M., et al. (2016) · Pain Medicine · doi:10.1093/pm/pnv055 · Cited by 23 · see citing works
Association between objectively measured physical activity and body mass index with low back pain: a large-scale cross-sectional study of Japanese men
Hashimoto, Y., Matsudaira, K., Sawada, S. S., Gando, Y., Kawakami, R., Sloan, R. A., Kinugawa, C., Okamoto, T., Tsukamoto, K., Miyachi, M., et al. (2018) · BMC Public Health · doi:10.1186/s12889-018-5253-8 · Cited by 24 · see citing works
A virtual reality intervention for fear of movement for Veterans with chronic pain: protocol for a feasibility study
Fowler, C. A., Ballistrea, L. M., Mazzone, K. E., Martin, A. M., Kaplan, H. M., Kip, K. E., Murphy, J. L., & Winkler, S. (2019) · Pilot and Feasibility Studies · doi:10.1186/s40814-019-0501-y · Cited by 23 · see citing works
Back Pain Beliefs Are Related to the Impact of Low Back Pain in Baby Boomers in the Busselton Healthy Aging Study
Beales, D. J., Smith, A. J., O’Sullivan, P., Hunter, M. L., & Straker, L. M. (2014) · Physical Therapy · doi:10.2522/ptj.20140064 · Cited by 22 · see citing works
Impact of education in patients undergoing physiotherapy for lower back pain: a level I systematic review and meta-analysis
Migliorini, F., Maffulli, N., Schäfer, L., Manocchio, N., Bossa, M., Calogero, F., Betsch, M., & Kubach, J. (2025) · European Journal of Trauma and Emergency Surgery · doi:10.1007/s00068-025-02788-9 · Cited by 24 · see citing works
Improving neuropathic pain treatment – by rigorous stratification from bench to bedside
Soliman, N., Kersebaum, D., Lawn, T., Sachau, J., Sendel, M., & Vollert, J. (2023) · Journal of Neurochemistry · doi:10.1111/jnc.15798 · Cited by 22 · see citing works
Resilience and Vulnerability Factors When Pain is Acute as Predictors of Disability: Findings From a Two-Year Longitudinal Study
Esteve, R., Bendayan, R., López-Martínez, A. E., & Ramírez‐Maestre, C. (2017) · Pain Medicine · doi:10.1093/pm/pnx053 · Cited by 21 · see citing works

The role of fear avoidance beliefs as a prognostic factor for outcome in patients with nonspecific low back pain: A systematic review
Wertli, M. M., Rasmussen-Barr, E., Weiser, S., Bachmann, L. M., & Brunner, F. (2014) · The Spine Journal · doi:10.1016/j.spinee.2013.09.036 · Cited by 479 · see citing works
Self-citation
Fear-avoidance beliefs and pain avoidance in low back pain--translating research into clinical practice.
Rainville, J., Smeets, R., Bendix, T., Tveito, T., Poiraudeau, S., & Indahl, A. (2011) · The spine journal · doi:10.1016/j.spinee.2011.08.006 · Cited by 209 · see citing works
A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability.
Waddell, G., Newton, M., Henderson, I., Somerville, D., & Main, C. J. (1993) · Pain · doi:10.1016/0304-3959(93)90127-b · Cited by 3,167 · see citing works
Clinical Course and Impact of Fear-Avoidance Beliefs in Low Back Pain
Grotle, M., Vøllestad, N. K., & Brox, J. I. (2006) · Spine · doi:10.1097/01.brs.0000214878.01709.0e · Cited by 161 · see citing works
Current evidence on catastrophizing and fear avoidance beliefs in low back pain patients
Brox, J. I. (2014) · The Spine Journal · doi:10.1016/j.spinee.2014.08.454 · Cited by 11 · see citing works

Authors: Wertli, M. M., Rasmussen-Barr, E., Held, U., Weiser, S., Bachmann, L. M., & Brunner, F.
Affiliations: University of Zurich (CH)
Karolinska Institutet (SE)
New York University Langone Orthopedic Hospital (US)
Universitätsklinik Balgrist (CH)
Corresponding author: Wertli, Maria M.
ORCID: Wertli, Maria M.
Rasmussen-Barr, Eva
Held, Ulrike
Weiser, Sherri
Bachmann, Lucas M.
Brunner, Florian
Venue: The Spine Journal
Publisher: Elsevier BV
Published: 2014-11
Volume: 14
Issue: 11
Pages: 2658-2678
ISSN: 1529-9430 (ISSN-L)
DOI: 10.1016/j.spinee.2014.02.033
OpenAlex: W1980544906
Cited by: 343
References: 75
Citations by year: 2026: 23 · 2025: 29 · 2024: 24 · 2023: 34 · 2022: 30 · 2021: 35 · 2020: 30 · 2019: 36 · 2018: 30 · 2017: 24 · 2016: 25 · 2015: 15 · 2014: 6
FWCI: 2.99
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Spine Journal (publishedVersion)
PubMed (publishedVersion)
Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Keywords: fear-avoidance beliefs, low back pain, kinesiophobia, treatment efficacy, return to work, disability, pain, chronic low back pain, conservative treatment, psychological factors, Tampa Scale for Kinesiophobia, moderators of treatment outcome, psychological intervention, work-related outcomes, treatment response prediction, treatment discontinuation
MeSH terms: Adult, Culture, Fear, Female, Persons with Disabilities, Humans, Male, Surveys and Questionnaires, Treatment Outcome, Low Back Pain, Chronic Pain

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Fear-avoidance beliefs—a moderator of treatment efficacy in patients with low back pain: a systematic review

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