A = Attitudes and beliefs

  1. Belief that pain is harmful or that it indicates ongoing physical damage. This may result in fear of anything that leads to more pain and avoidance of activities expected to be painful.
  2. Belief that the injury must be diagnosed and treated first.
  3. Belief that they are unable to function in pain and pain relief must occur before attempting to return to normal activity including work.
  4. Expectation of increased pain with activity or work, and a lack of ability to predict personal capacity.
  5. Perception of the injury as a catastrophe, thinking the worst, misinterpreting bodily symptoms, and assigning all problems to the injury.
  6. Belief that pain is uncontrollable.
  7. Passive, symptom-focused attitude to rehabilitation and return to work.