Top 5 Fridays! 5+ Steps for Reconceptualizing Pain-Related Fear Through Exercise

Reconcepiualizing Pain Related Fear by Cameron Faller

Many individuals with pain will become fearful of movement, or exercise, if it appears to provoke symptoms. With the knowledge that exercise can be beneficial despite pain, here are 6 practical steps clinicians can take to reconceptualize this fear.

Reposted with permission from Dr. Cameron Faller, DPT

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👉Understand What The Patient Understands - Provide questions that elicits information about their beliefs and perceptions as to why they have pain in the first place.
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👉Challenge Unhelpful Beliefs - Question their beliefs about their safety with exercise. Prescribe exercises or movements that were previously avoided/or painful. New associations may form that inhibit prior fear.
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👉Enhance Self-Efficacy - Ask them their level of confidence when performing a specific exercise. Discuss what might occur when they perform that exercise. Begin with easier exercises and progress to more difficult which may build self-efficacy.
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👉Provide Safety Cues - Validate reasons as to why tissues may be sensitive given disuse. Provide information about building tolerance and strength to carry over towards functional deficits.
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👉Provide Advice on Suitable Levels for Pain - Find an acceptable and tolerable level of pain for your patients and try to keep exercises within its range. Educate on recovery and having symptoms calm down over 24 hours modifying if pain persists longer than that time period.
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👉Provide Advice on Exercise Modification - Find the sweet spot. Don’t make activities too easy that have no functional carryover. If an exercise is too painful, educate on ways to reduce load, modify range, or change position to decrease symptom provocation.
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Exercise has many therapeutic benefits mentally and physically especially for individuals in pain. DON’T let pain be a barrier to receiving successful outcomes.
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“Aspire to Inspire”
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Reference: Smith BE, Hendrick P, Bateman M, et al. Musculoskeletal pain and exercise-challenging existing paradigms and introducing new. Br J Sports Med. 2019;53(14):907-912.

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This article was originally posted on Modern Manual Therapy Blog

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