Kinesiophobia among physiological overusers with musculoskeletal pain

Kinesiophobia has been established as an important factor among patients with musculoskeletal pain. Most research has been performed among patient groups described in terms of disuse. Little, however, is known about the impact of affective factors among patients with overuse injuries caused by exercise.

The aims were to investigate the occurrence of kinesiophobia among patients with exercise induced pain (overuse group) as compared to a reference group (chronic low back pain, CLBP), and to investigate kinesiophobia in relation to the type of pain and levels of exercise in the overuse group.

All patients were referred with unspecific pain to the orthopaedic clinic in order to make a specific diagnosis. The overuse group consisted of 146 patients with exercise induced leg pain, and the reference group consisted of 154 patients with CLBP. All patients completed questionnaires regarding age, pain duration, severity of pain and subjective rating of kinesiophobia (TSK). The overuse group was subgrouped verified by an exercise test and diagnostic criteria and completed questionnaires about the level of exercise.

More than 60% of the overusers presented with kinesiophobia, but they did not differ as compared to the reference group. No difference in kinesiophobia was found in the overuse subgroups divided after type of pain. The highest level of kinesiophobia was found among the non-exercisers.

The results of this study point out the need for further elaborating on the concepts of use, overuse and disuse in relation to the fear-avoidance model.