Relationship between knowledge of pain neurophysiology and fear avoidance in people with chronic pain

Mrs Claire Fletcher2

1Healthscope, Melbourne, Australia

2Flinders University Clinical Rehabilitation Department , Adelaide, Australia


To explore the relationship between knowledge of pain neurophysiology and fear avoidance in individuals diagnosed with chronic pain.


Twenty nine people (20 female) with a mean age of 48.6(SD11.3) with chronic pain of a mean duration of 79.2 (SD108.6) months took part in this point in time observational study. Participants completed validated tests of pain including the revised Neurophysiology of Pain Questionnaire (rNPQ) to determine their understanding of chronic pain mechanisms. They were also tested on the Tampa Scale of Kinesiophobia (TSK), to assess the degree of their fear avoidance beliefs. Perceived disability, educational level, and compensable status were also examined.


Patients had experienced pain for greater than 6 months and had been given a diagnosis of with chronic pain by a pain rehabilitation specialist. Those with higher pain knowledge reported less fear avoidance (r=-0.41, p=0.029) and lower perceived disability (r=-0.45, p=0.014) related to pain. There was no relationship with educational level or compensable status for either variable.

Significance of finding to Allied Health:

The findings show that kinesiophobia may be positively influenced by the neurophysiological and psychological determinants of pain education, as a higher levels of pain knowledge was associated with less activity-related fear. Reducing fear avoidance by providing pain education to people with chronic pain may deliver an effective strategy to help manage the fear avoidance behaviours and related disability. Pain education can provide a cost effective and easy to apply intervention in the clinical setting for people living with chronic pain.