Psychosocial Issues

Multidisciplinary Rehabilitation Treatment of Patients With Chronic Low Back Pain: A Prognostic Model for Its Outcome

“…There are also numerous reviews that have studied other predictive factors for different treatment modalities or outcome measures. Consistent results were found for maladaptive beliefs 4,5 and depression [5][6][7] ; both were associated with poor outcome. Sick leave or compensation status were predictive of less return to work 4,6,[8][9][10] and of reduced treatment response in general.…”

Outcomes and prognostic variables of radiofrequency zygapophyseal joint neurotomy in Utah workers’ compensation patients

“…We are aware of only one other study that found pre-procedure depression to be a predictor of RFN outcomes,29 although this has been a consistent finding in the spine surgery literature 21,22,24,26. Although the precise mechanism of how depression negatively influences outcomes is unknown, we believe that depression likely exacerbates patients’ pain experiences and also negatively influences expectations for recovery following medical interventions, and these issues in turn lead to chronicity.…”

“…There have also been no published RFN studies that have solely examined compensated patient outcomes. Numerous studies in spine surgery have also consistently found that presurgical psychosocial variables are consistent correlates of outcomes, particularly among compensation patients,24–28 although this has also not been established in the RFN literature. We are aware of only one observational trial that linked depression with shorter duration of pain relief following RFN 29…”

Clinical Guidelines Versus Clinical Practice in the Management of Low Back Pain

“…As a result of mounting evidence, the UK clinical guidelines give very specific recommendations that initial clinical assessment should include ‘psychological, occupational and socioeconomic factors in the patient's life since non‐physical factors can complicate both assessment and treatment’ 20 . Current physiotherapy education does not provide physiotherapists with the skills to conduct a biopsychosocial assessment, but questionnaires can be used for this purpose and several are available for assessing LBP and disability 21–25 . Despite the guidelines' clear recommendations, and the important part physiotherapists are expected to play in identifying biopsychosocial risk factors in patients with LBP, there was little evidence of this approach being adopted in the clinical setting.…”