Matched clinical terms: questionnaire, questionnaire — may affect guidance relevant to Fear-Avoidance Beliefs Questionnaire (FABQ).
Fear-Avoidance Beliefs Questionnaire (FABQ)
Physical Activity
0 / 24
Work Subscale
0 / 42
Item 1(Unscored filler)
My pain was caused by physical activity.
Item 2
Physical activity makes my pain worse.
Item 3
Physical activity might harm my back.
Item 4
I should not do physical activities which (might) make my pain worse.
Item 5
I cannot do physical activities which (might) make my pain worse.
Item 6(Unscored filler)
My pain was caused by my work or by an accident at work.
Item 7
My work aggravated my pain.
Item 8(Unscored filler)
I have a claim for compensation for my pain.
Item 9
My work is too heavy for me.
Item 10
My work makes or would make my pain worse.
Item 11
My work might harm my back.
Item 12
I should not do my normal work with my present pain.
Item 13(Unscored filler)
I cannot do my normal work with my present pain.
Item 14(Unscored filler)
I cannot do my normal work until my pain is treated.
Item 15
I do not think that I will be back to my normal work within 3 months.
Item 16(Unscored filler)
I do not think that I will ever be able to go back to that work.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Assessment of fear-avoidance beliefs in athletes with musculoskeletal injuries (primarily low back pain).
Identifying patients at risk for chronic disability and prolonged time away from sport.
Initial assessment and tracking throughout physical therapy.
Clinical Objective
The FABQ helps distinguish between fear-avoidance (avoiding movement due to fear of harm) and appropriate protective behavior.
Section 2
Formula & Logic
Structure & Scoring
01
16 Items: Rated 0 (Completely Disagree) to 6 (Completely Agree).
02
Subscale 1: Physical Activity (FABQ-PA). Sum of items 2, 3, 4, 5 (Max 24).
03
Subscale 2: Work (FABQ-W). Sum of items 6, 7, 9, 10, 11, 12, 15 (Max 42).
04
Distractors: Items 1, 8, 13, 14, 16 are not scored.
High-Risk Cut-offs
FABQ-PA
> 15
FABQ-W
> 34
Section 3
Pearls/Pitfalls
Predictive Value
High FABQ scores are strong predictors of poor outcome and failure to return to work/sport, often carrying more weight than the severity of the initial anatomical injury. Early identification allows for "Yellow Flag" management strategies.
Clinical Pearls
Patients with high fear-avoidance respond best to "Movement as Medicine" education.
Avoid "catastrophizing" language (e.g., "bone on bone," "slipped disk") which can drive FABQ scores higher.
The Work subscale (FABQ-W) is particularly useful in managing collegiate/pro athletes with contractual or vocational concerns.
Section 4
Next Steps
Management Considerations
01
Education: Focus on the safety of movement and the "hurt ≠ harm" principle.
02
Graded Exposure: Slowly re-introduce feared movements in a structured way.
03
Psychology Referral: Indicated for extremely high scores resistant to PT-led education.
Related Tools
Tampa Scale of Kinesiophobia (TSK)
STarT Back Tool
Oswestry Disability Index (ODI)
Section 5
Evidence Appraisal
Key Reference
A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability.
Waddell G et al. • Pain. 1993;52(2):225-44. The landmark study introducing and validating the FABQ.