Patient Information Resources

Centre for Orthopaedics
Suite 10-33/34/35 Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road
Singapore, 329563, Singapore
Ph: (65) 6684 5828
Fax: (65) 6684 5829

Child Orthopedics
Pain Management
Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

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I confess I'm a nervous Nellie kind of person. I hurt my back at work and now I'm really worried about re-injuring myself. What can I do to get over this?

Avoiding certain activities or movements that might cause pain or reinjury is called fear-avoidance behavior. This may be what you are describing about yourself. And you are right to be concerned. Chronic pain can be disabling.

The Fear-Avoidance Model of Exaggerated Pain Perception (FAMEPP) was first introduced in the early 1980s. The idea is based on studies that show a personís fear of pain (not physical problem) is the most important factor in how he or she responds to low back pain. Fear of pain commonly leads to avoiding physical or social activities.

Education is the key to injury prevention and fear avoidance behaviors. You've already taken the first step to getting over this problem: you've seen it! A physical therapist may be able to help you. First youíll be tested for fear avoidance behaviors. A series of questions are asked to find this out. When a patient shows signs of fear-avoidance beliefs, then the therapistís management approach will include education.

The therapist can teach you about the difference between pain and tissue injury. Chronic ongoing pain does not mean tissue injury is taking place. This common misconception is another reason why patients use movement avoidance behaviors. Then you'll be given a graded approach to exercise. The therapist will guide you through the activities and movements that cause you the most fear.


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