Fear and Anxiety in the Transition from Acute to Chronic Pain: There is Evidence for Endurance Besides Avoidance

SUMMARY 

Substantial evidence reveals that the fear of pain and pain anxiety play a significant role in the development of chronic pain and disability, although underlying mechanisms remain widely unknown. Recent studies indicate that endurance pain responses are important besides avoidance. The purpose of this brief narrative review is to provide an overview of research that argues for the integration of the mechanisms of associative learning, motivation and emotion regulation in order to understand the questions of how and why individuals respond with pain responses, which lead to long-term suffering. By using the avoidance–endurance model of pain, we provide a concept that elucidates a range of responses to pain, fear and anxiety that mediate the transition from acute to chronic pain.

KEYWORDS:

• anxiety
• avoidance
• endurance
• fear
• goal pursuit
• stages of pain
• thought suppression

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing assistance was utilized in the production of this manuscript. The manuscript was edited by American Journal Experts with the costs covered by the authors’department (Department of Medical Psychology & Medical Sociology, Ruhr-University of Bochum).