The fear-avoidance model of musculoskeletal pain is a cognitive-behavioral framework that explains why a minority of acute low back pain (LBP) sufferers develop chronic pain. This review examines the current scientific evidence for the individual components of the model, including pain severity, pain catastrophizing, attention to pain, escape/avoidance behavior, disability, disuse, and vulnerabilities. The model suggests that pain-related fear and associated behaviors can lead to a vicious cycle of disability and disuse, contributing to the maintenance of chronic pain. Recent studies have highlighted the role of pain-related fear in the inception and continuation of LBP, as well as its potential as a risk factor for new pain episodes in pain-free individuals. Cognitive behavioral programs, particularly exposure in vivo, have shown promise in reducing fear-related fear and improving functional outcomes. However, the generalization of these treatments to daily life remains a challenge. Future research should explore the contextual factors influencing the occurrence and reinstatement of fear, as well as the causal relationships between the components of the fear-avoidance model.The fear-avoidance model of musculoskeletal pain is a cognitive-behavioral framework that explains why a minority of acute low back pain (LBP) sufferers develop chronic pain. This review examines the current scientific evidence for the individual components of the model, including pain severity, pain catastrophizing, attention to pain, escape/avoidance behavior, disability, disuse, and vulnerabilities. The model suggests that pain-related fear and associated behaviors can lead to a vicious cycle of disability and disuse, contributing to the maintenance of chronic pain. Recent studies have highlighted the role of pain-related fear in the inception and continuation of LBP, as well as its potential as a risk factor for new pain episodes in pain-free individuals. Cognitive behavioral programs, particularly exposure in vivo, have shown promise in reducing fear-related fear and improving functional outcomes. However, the generalization of these treatments to daily life remains a challenge. Future research should explore the contextual factors influencing the occurrence and reinstatement of fear, as well as the causal relationships between the components of the fear-avoidance model.