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 .
Patients with persistent medically unexplained symptoms in general practice: characteristics and quality of care
Background Medically unexplained physical symptoms ( MUPS ) are common in general practice ( GP ) , and are even more problematic as they become persistent . The present study examines the relationship between persistent MUPS in general practice on the one h and and quality of life , social conditions , and coping on the other h and . Additionally , it is examined how patients with persistent MUPS  evaluate the quality of GP-care . Methods Data were used from a representative survey of morbidity in Dutch general practice , in which data from the electronic medical records were extracted . A r and om sample of patients participated in an extensive health interview and completed self-reported measures on social isolation , coping and the quality of GP-care .  Patients with persistent MUPS ( N = 192 ) were compared with general practice patients not meeting the criteria for persistent MUPS ( N = 7.314 ) , and with a group of patients that visited the GP in comparable rates for medical diagnoses ( N = 2.265 ) . Multiple logistic regression analyses were used to control for relevant socio-demographic variables and chronic diseases . Results After adjustment for demographics and chronic diseases , patients with persistent MUPS reported more psychological distress , more functional impairment , more social isolation , and they evaluated the quality of GP-care less positive than the other two patient groups . Although the majority of MUPS patients were positive about the quality of GP-care , they more often felt that they were not taken seriously or not involved in treatment decisions , and more often reported that the GP did not take sufficient time . The three groups did not differ with respect to the statement that the GP unnecessarily explains physical problems as psychological ones . ConclusionS trengthening MUPS patients ' social network and encouraging social activities may be a meaningful intervention in which the GP may play a stimulating role . To further improve MUPS patients ' satisfaction with GP-care , GPs may pay extra attention to taking sufficient time when treating MUPS patients , taking the problems seriously , and involving them in treatment decisions
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 .