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 .
Can we screen for problematic back pain? A screening questionnaire for predicting outcome in acute and subacute back pain.
OBJECTIVES Because musculoskeletal pain is the second most frequent reason for seeking health care , the aims of this study were to determine the value of psychosocial variables in evaluating risk for developing chronic back pain problems and to develop a screening methodology to identify patients likely to have a poor prognosis . STUDY DESIGN A prospect i ve study was conducted on consecutive patients with acute or subacute back pain , in which patients completed a screening question naire and were then followed up for 6 months to determine outcome . The primary outcome variable was accumulated sick leave . METHODS One hundred forty-two consecutive patients were asked to complete a question naire design ed for this study . This question naire contained 24 items concerning psychosocial aspects of the problem . Six months later , patients were contacted to complete outcome questions about accumulated sick leave .  RESULTS A total of 97 % of the patients completed both question naires . Although patients , on average , improved greatly , 18 % had 1 - 30 days and 20 % had fewer than 30 days of sick leave during the follow-up period . Five variables were found to be the strongest predictors of sick leave outcome ( fear-avoidance work beliefs , perceived improvement , problems with work function , stress , and previous sick leave ) , correctly classifying 73 % of the patients as opposed to a chance rate of 33 % . A total score was evaluated as a means of judging risk and found to be strongly related to outcome . CONCLUSION Potent psychosocial risk factors associated with future sick absenteeism were identified . Because the total score was related to outcome , the instrument may have use in screening patients with acute or subacute spinal pain in clinical situations
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 .