It is quite common for pain sufferers to avoid rehabilitation exercises out of a reluctance to endure the discomfort they cause. However, when this avoidance becomes pathological, it is called kinesiophobia. Many people with chronic pain develop this type of avoidance behavior in an effort to minimize exposure to additional pain or re-injury.
Kinesiophobia is most commonly seen in patients with long-term pain, such as low back pain, where movement can produce strong pain symptoms or even aggravate an injury. In most cases, although there is a reasonable risk of pain, the risk of making an existing injury or condition worse is minimal. This is why kinesiophobia is defined as an excessive or irrational fear of movement.
The effects of kinesiophobia.
Kinesiophobia can produce a wide variety of physical and psychological effects. The nature and severity of these effects may depend on a variety of factors, including the intensity of the pain symptoms, the duration of the painful condition, and access to effective physical therapy. Among the possible consequences of untreated kinesiophobia are the following:
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Limited range of motion :
Because people with kinesiophobia are unwilling to do stretching and strengthening exercises, they often exhibit a lower range of motion than people with comparable chronic pain.
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Distorted motor coordination :
Many people who fear certain types of movement can compensate by adopting a modified movement. This can produce unconventional strain on joint tissues and muscles. Which can lead to pain or secondary health problems.
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The catastrophizing of pain :
One of the biggest challenges in treating kinesiophobia is alleviating the intensification of symptoms. Because the neural pathways that govern fear and pain overlap, fear of pain can make even modest stimuli seem much worse than they actually are.
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Decreased quality of life :
Due to an almost paralyzing fear of movement, many people with kinesiophobia are severely limited in their ability to perform the simplest of activities. Limited functionality often leads to reduced independence or even disability. This can have a significant impact on quality of life.
Although they try to avoid increased pain by limiting their movements, people with kinesiophobia often experience increased pain due to disuse and incapacity. Joints and muscles can atrophy and stiffen, making even everyday movement more difficult and painful. This disuse can lead to painful secondary health issues or even re-injury.
How to treat kinesiophobia?
Treating kinesiophobia can be a complex task. Kinesiophobia is most often diagnosed during physical therapy, but it may require a multidisciplinary approach. Although there may be physical barriers to rehabilitation, such as swelling, scar tissue, or intense discomfort, the main problem for most people with kinesiophobia is the overwhelming fear of impending pain.
There are techniques a physical therapist can use to ease this fear. Nevertheless, in some cases where kinesiophobia is debilitating, it may be necessary to include a psychotherapist in the treatment. Once the patient is able to manage the pain, physical therapy can then proceed unhindered.
Here are some common treatment techniques for kinesiophobia:
Untangling Pain and Injury :
One of the main reasons many patients want to avoid pain is to prevent another injury. Certainly, many people with kinesiophobia mistakenly associate all kinds of pain with bodily harm. These patients should be made aware that pain is sometimes beneficial. In some cases, it may be necessary to bring in a therapist to counsel the patient.
Associate movement with pleasure :
An important way to overcome the fear of movement is to associate it with pleasure. It is not necessarily a physical activity. Instead, you can work with a medical professional to imagine pleasurable movements. Like walking on a beach or playing your favorite musical instrument. You should try to imagine all the details of such an activity, including the movements of joints and muscles, so that you can look forward to the actual movement.
Painkillers :
In some cases, it may be appropriate to use pain medication to limit pain symptoms during physical therapy. Initially, this medication regimen should be limited to over-the-counter anti-inflammatory pain relievers. But some doctors may resort to prescription opioids if needed.
