Kinesiophobia, or the fear of movement, is a common psychological correlate of chronic back pain. People with kinesiophobia tend to believe that the pain they experience upon performing certain movements or actions is causing their injury or condition to worsen, or that they will not be able to tolerate the pain; therefore they decrease their physical activity levels significantly.
Unfortunately, kinesiophobia tends to cause pain conditions to worsen rather than serve any protective function; anxiety is thought to cause people to feel more physical pain due to the mind-body connection. Also, a lack of movement inhibits healing and weakens structures in and around the back, thereby creating an environment for further degenerative problems.
Movement is important for chronic back pain patients not only because it helps the body heal, but because being active is such a crucial component of one’s quality of life. People who fear movement tend to stop the activities they love. Some may even stop walking. Chronic pain and depression share a strong connection, and depression is more likely if you severely restrict your activity level. For both physical and mental health, it is imperative that you address kinesiophobia as part of your treatment plan.
Those who treat kinesiophobia generally begin by attempting to inform the patient that hurt doesn’t always equal harm. A therapist can work with you to identify the counterproductive and false beliefs you may hold toward pain. For example, you may avoid bending down because you picture your vertebrae grinding together, but this may not be what’s happening at all. Once these beliefs have been acknowledged, you can move on to a technique called graded exposure.
Graded exposure is a technique therapists and physical therapists may implement to gradually increase your confidence in your ability to move. In this approach, you identify the movements and actions that you fear and rank them based on how feared they are. With the guidance of a physical therapist, you perform the motions from least to most feared. It is best to work with a team of physical and mental health professionals; a physical therapist or doctor can identify what movements might actually be harmful.
Graded activity is a similar technique that takes patients through different movements that aren’t specified by the patient as feared but are chosen by your health professional implementing the therapy. One study, found at http://www.ncbi.nlm.nih.gov, showed that both therapies reduced pain and depression in 50% of participants and disability and catastrophizing in 30%.
Staying active is a critical component of back pain treatment. If you suspect kinesiophobia is interfering with your life, ask your doctor to administer the Tampa Scale for Kinesiophobia test.