Episode 36: Fear Avoidance in Patients & Providers

In this episode, we explore fear avoidance. As humans, we all experience fear and some of us exhibit fear avoidance behaviors. As people exhibit more fear avoidance, they also report higher pain intensity levels. This has consistently shown up in pelvic pain, pelvic girdle pain, and persistent musculoskeletal conditions. 

We talk through Sammy’s patient who exhibited high fear avoidance and how they began confronting it. We also explore how fear-avoidance influenced Monika’s clinical practice and how often we see this with healthcare providers. It’s not just patients who demonstrate fear-avoidance! In order to do no harm, we need to be aware of our own beliefs and how that shapes our practice too. We hope this one helps you consider fear-avoidance in your work! 

 

Highlights from our conversation in Episode 36

• (0:34) What is fear-avoidance 
• (1:45) A case of high fear-avoidance 
• (4:50) Addressing the patient’s fears head-on 
• (8:16) Graded exposure to reduce fear  
• (12:26) Healthcare providers also demonstrate fear-avoidance!
• (17:51) Factors that contribute to our individual differences in fear 
• (20:32) Changing our own and our patient’s beliefs 

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Resources from Episode 36

• The fear-avoidance article we reference! (1:08, 12:41) Rainville J, et al. Fear-avoidance beliefs and pain avoidance in low back pain—translating research into clinical practice. 2011;11(9), 895–903.         doi:10.1016/j.spinee.2011.08.006     
• (10:29) Episode 3: Identifying Patient's Readiness to Change
• (20:45) Episode 5: All About Pain Catastrophizing 
• Pop Up Pro Annemarie Everett, DPT, WCS (21:13) Episode 11: Authentic Evidence Based Practice with Dr. Annemarie Everett, DPT, WCS
• Confronting fear avoidance beliefs with Katie (26:38) Episode 20: A Patient's Perspective of Conscious PT Practice with Katie

Additional listening: Episode 15: The Power of Understanding Patient Beliefs with Dr. Mike Nelson, DPT

 

Additional reading: 

• Alappattu M, Bishop, M. Psychological factors in chronic pelvic pain in women: relevance and application of the fear-avoidance model of pain. Phys Ther. 2011; 91(10):1542-50. doi: 10.2522/ptj.20100368. 
• Fakari F, Simbar M, Saei Ghare Naz, M. The Relationship between Fear-Avoidance Beliefs and Pain in Pregnant Women with Pelvic Girdle Pain: A Cross-Sectional Study. Int J Community Based Nurs Midwifery. 2018;6(4):305-313.

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