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 .
The impact of specialist care for low back pain on health service utilization in primary care patients: A prospective cohort study
Guidelines portray low back pain ( LBP ) as a benign self‐limiting disease which should be managed mainly by primary care physicians . For the German health care system we analyze which factors are associated with receiving specialist care and how this affects treatment . This is a longitudinal prospect i ve cohort study . General practitioners recruited consecutive adult patients presenting with LBP .  Data on physical function , on depression , and on utilization of health services were collected at the first consultation and at follow‐up telephone interviews for a period of 12 months .  Logistic regression models  were calculated to investigate predictors for specialist consultations and use of specific health care services . Large proportions ( 57 % ) of the 1342 patients were seeking additional specialist care . Although patients receiving specialist care had more often chronic LBP and a positive depression score , the association was weak . A total of 623 ( 46 % ) patients received some form of imaging  , 654 ( 49 % ) physiotherapy and 417 ( 31 % ) massage . Consulting a specialist remained the strongest predictor for imaging and therapeutic interventions  while disease‐related and socio‐demographic factors were less important . Our results suggest that the high use of specialist care in Germany is due to the absence of a functioning primary care gate keeping system for patient selection . The high dependence of health care service utilization on providers rather than clinical factors indicates an un systematic and probably inadequate management of LBP
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 .