Which statement defines fear-avoidance in physical therapy?

• A. Fear-avoidance is when a patient avoids activity due to fear of pain or re-injury.
• B. Fear-avoidance is a general lack of motivation to exercise.
• C. Fear-avoidance is a sign of malingering.
• D. Fear-avoidance is a sign of neuropathic pain.

Answer: (A)

Fear-avoidance describes a pattern where a patient avoids activities because they fear that movement will cause pain or a re-injury. This fear-driven avoidance can lead to less activity, deconditioning, and greater disability, even when the tissue is not actually damaged or at risk.

This is why the statement is the best fit: it directly links avoidance to fear of pain or re-injury, capturing the cognitive-behavioral process that PTs address. It’s not simply about motivation, malingering, or a specific pain type like neuropathic pain—the others describe different explanations for behavior or symptoms.

In practice, recognizing fear-avoidance informs treatment: you validate concerns, provide education to reframe pain, and use graded activity or exposure to help patients move confidently again.