Acta Scientific Orthopaedics (ISSN: 2581-8635)

Review Article Volume 3 Issue 12

Addressing Fear Avoidance and Self-efficacy Beliefs to Reduce Disability in Patients with Non-specific Low Back Pain: From Theory to Application

George A Koumantakis1,2*

1Assistant Professor, Department of Physiotherapy, University of West Attica (UNIWA), Athens, Greece
2Director, Laboratory of Advanced Physiotherapy (LAdPhys), Department of Physiotherapy, University of West Attica (UNIWA), Athens, Greece

*Corresponding Author: George A Koumantakis, Laboratory of Advanced Physiotherapy (LAdPhys), Department of Physiotherapy, University of West Attica (UNIWA), Athens, Greece.

Received: October 27, 2020; Published: November 18, 2020



  A considerable proportion of patients with non-specific low back pain (nsLBP) report continued symptoms for an extended period of time. In many cases no structural lesion can be identified. Biopsychosocial models attempt to identify the contribution of several psychosocial factors contributing to the development and maintenance of chronic disability in these patients. The fear avoidance model postulates that patients may respond to pain with an avoidance behavior, reducing the level of their activities, resulting in a vicious cycle of prolonged disability, disuse and further pain experience. The aim of this mini-review is to present some of the most relevant evidence on the interrelationship of fear avoidance as well as self-efficacy beliefs with disability in patients with nsLBP and physical therapy-related methods targeting disability improvement through fear amelioration techniques. It is concluded that fear is a contributing factor leading to greater levels of disability in individuals suffering an acute episode and is also influencing patient disability further in the subacute and chronic stage of symptoms, also affecting LBP recurrence rate. Results of some studies indicate that there may be additional cognitive factors, like self-efficacy, influencing the outcome of therapy, mainly for those experiencing acute back pain symptoms. Further investigations should take into account and examine the joint contribution of such psychological factors in order to implement effective and targeted therapy interventions for patients with back pain.

Keywords: Cognitive Factors; Psychosocial; Chronicity; Physical Therapy; Graded Exposure; Pain Neuroscience Education



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Citation: George A Koumantakis. “Addressing Fear Avoidance and Self-efficacy Beliefs to Reduce Disability in Patients with Non-specific Low Back Pain: From Theory to Application".Acta Scientific Orthopaedics 3.12 (2020): 43-51.


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