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 .
Characterizing the course of low back pain: a latent class analysis.
Underst and ing the course of back pain is important for clinicians and research ers , but analyses of longitudinal data from multiple time points are lacking . A prospect i ve cohort study of consecutive back pain consulters from five general practice s in the United Kingdom was carried out between 2001 and 2003 to identify groups defined by their pain pathways . Patients were sent monthly question naires for a year . Longitudinal latent class analysis was performed by using pain intensity scores for 342 consulters . Analysis yielded four clusters representing different pathways of back pain . Cluster 1 ( " persistent mild " ; n = 122 ) patients had stable , low levels of pain . Patients in cluster 2 ( " recovering " ; n = 104 ) started with mild pain , progressing quickly to no pain . Cluster 3 ( " severe chronic " ; n = 71 ) patients had permanently high pain . For patients in cluster 4 ( " fluctuating " ; n = 45 ) , pain varied between mild and high levels . Distinctive patterns for each cluster were maintained throughout follow-up . Clusters showed statistically significant differences in disability , psychological status , and work absence ( p < 0.001 ) . This is the first time , to the authors ' knowledge , that latent class analysis has been applied to longitudinal data on back pain patients . Identification of four distinct groups of patients improves underst and ing of the course of back pain and may provide a basis of classification for intervention
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 .