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 .
Biomechanical constraints remain major risk factors for low back pain. Results from a prospective cohort study in French male employees.
BACKGROUND CONTEXT Low back pain ( LBP ) is a major public health problem , with a considerable impact on workers . PURPOSE To model the risk of LBP in the male general working population . STUDY DESIGN / SETTING Repeated cross-sectional surveys in a wide occupational setting . PATIENT SAMPLE A r and om sample of 2,161 men working in various occupations in a French region participated in a first survey in 2002 , and 1,313 of these ( 60.8 % ) participated in a second survey in 2007 . OUTCOME MEASURE The self-reported prevalence of LBP during the previous week in the second survey . METHODS Twenty-one biomechanical , organizational , psychosocial , and individual factors were assessed in the first survey . The association between these potential risk factors and the prevalence of later LBP ( in the second survey ) was studied , using multistep logistic regression models . RESULTS Three hundred ninety-four men reported LBP in the second survey ( prevalence 30.0 % ) . The final multivariate model highlighted four risk factors : frequent bending ( odds ratio [ OR ] , 1.45 , 95 % confidence interval [ CI ] , 1.07 - 1.97 for bending forward only ; and OR , 2.13 , 95 % CI , 1.52 - 3.00 for bending both forward and sideways ) , driving industrial vehicles ( OR , 1.35 ; 95 % CI , 1.00 - 1.81 ) , working more hours than officially planned ( OR , 1.38 ; 95 % CI , 1.05 - 1.81 ) , and reported low support from supervisors ( OR , 1.35 ; 95 % CI , 1.02 - 1.79 ) . CONCLUSIONS These results emphasize that biomechanical factors remain worth considering , even when psychosocial factors are taken into account , and provide a significant contribution to preventive strategies
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 .