In the first systematic review , the patients ' or HCPs ' overall judgment about the likely evolution of LBP was the factor most strongly linked to poor outcome , with predictive validity similar to that of multidimensional scales .
This result may be explained by the implicit aggregation of many prognostic factors underlying this judgment and suggests the relevance of considering the patients from biopsychosocial and longitudinal points of view .
It is unlikely that any intervention focusing on a single factor would ever fit the needs of most patients ; interventions targeting determinants from several fields ( mainly psychosocial , biomechanical , and occupational ) may be more relevant .
Finally , in the third study , the prevalence of psychosocial comorbidity in chronic LBP patients was not found to be significantly higher than in other patients consulting in primary care .
Rather than specifically screening for psychosocial conditions , this suggests taking into account any potential comorbidity in patients with chronic LBP , as in other patients .
As this condition is illustrative of many situations encountered in primary care , the strategies proposed here may benefit most patients consulting in this setting
Non-specific low back pain ( LBP ) affects many people and has major socio-economic consequences .
Traditional therapeutic strategies , mainly focused on biomechanical factors , have had moderate and short-term impact .
Certain psychosocial factors have been linked to poor prognosis of LBP and they are increasingly considered as promising targets for management of LBP .
Primary health care providers ( HCPs ) are involved in most of the management of people with LBP and they are skilled in providing comprehensive care , including consideration of psychosocial dimensions .
This review aims to discuss three pieces of recent research focusing on psychosocial issues in LBP patients in primary care .
Medically unexplained symptoms--GPs' attitudes towards their cause and management.
BACKGROUND Medically unexplained physical symptoms present one of the most common problems in modern medical practice but often prove difficult to manage . The central position of the GP in the care of patients with medically unexplained symptoms has been emphasized repeatedly , but little is known about the attitudes of GPs to this role . Underst and ing how GPs view these patients may inform the development of effective strategies for management . OBJECTIVE Our aim was to survey the attitudes of UK GPs towards medically unexplained symptoms  ( MUS ) and somatization . METHODS A r and om sample of 400 GPs in the South Thames ( West ) region were surveyed using a postal question naire . Respondents ' attitudes toward the cause and management of MUS were recorded . RESULTS A total of 284 completed question naires were returned ( 22 returned incomplete ) , giving an adjusted response rate of 75 % . Although it was broadly felt that patients with MUS are difficult to manage , most GPs felt that patients with MUS should be managed in primary care . Providing reassurance , counselling and acting as a ' gatekeeper ' to prevent inappropriate investigations were considered important roles for GP management . A majority felt that patients with MUS have personality problems or psychiatric illness . Fewer than half of the respondents felt that there are effective treatments available for somatization . CONCLUSION GPs consider the management of patients with MUS to be an important part of their workload , but there is a perception that effective management strategies are lacking . Psychiatrists need to offer greater support and training for GPs in this area of health care
In the first systematic review , the patients ' or HCPs ' overall judgment about the likely evolution of LBP was the factor most strongly linked to poor outcome , with predictive validity similar to that of multidimensional scales .
This result may be explained by the implicit aggregation of many prognostic factors underlying this judgment and suggests the relevance of considering the patients from biopsychosocial and longitudinal points of view .
It is unlikely that any intervention focusing on a single factor would ever fit the needs of most patients ; interventions targeting determinants from several fields ( mainly psychosocial , biomechanical , and occupational ) may be more relevant .
Finally , in the third study , the prevalence of psychosocial comorbidity in chronic LBP patients was not found to be significantly higher than in other patients consulting in primary care .
Rather than specifically screening for psychosocial conditions , this suggests taking into account any potential comorbidity in patients with chronic LBP , as in other patients .
As this condition is illustrative of many situations encountered in primary care , the strategies proposed here may benefit most patients consulting in this setting
Non-specific low back pain ( LBP ) affects many people and has major socio-economic consequences .
Traditional therapeutic strategies , mainly focused on biomechanical factors , have had moderate and short-term impact .
Certain psychosocial factors have been linked to poor prognosis of LBP and they are increasingly considered as promising targets for management of LBP .
Primary health care providers ( HCPs ) are involved in most of the management of people with LBP and they are skilled in providing comprehensive care , including consideration of psychosocial dimensions .
This review aims to discuss three pieces of recent research focusing on psychosocial issues in LBP patients in primary care .