Chapter 40
Psychosocial Factors in Low Back Pain Management
James E. Moore,
Sean J. Tollison,
James E. Moore
Search for more papers by this authorSean J. Tollison
Search for more papers by this authorJames E. Moore,
Sean J. Tollison,
James E. Moore
Search for more papers by this authorSean J. Tollison
Search for more papers by this authorBook Editor(s):David I. Mostofsky,
David I. Mostofsky
Search for more papers by this authorFirst published: 28 March 2014
Summary
The failure of the biomedical model to yield improved outcomes for chronic low back pain (CLBP) prompted the adoption of a biopsychosocial model recognizing the reciprocal influences of cognitive, emotional, behavioral, and social/work environmental factors and how they interact with the biomedical factors of injury, nociception, and pain perception. This chapter reviews common psychosocial issues related to CLBP, including factors that influence the onset of pain, the transition from acute to chronic pain, responsiveness to treatment, and the maintenance of chronic pain and disability. Cognitive behavioral therapy with LBP patients includes teaching them to identify, challenge, and replace dysfunctional pain beliefs, and helping them to confront and overcome excessive fears and avoidance behaviors. When psychosocial issues are severe and recovery is significantly delayed without medical explanation, an intensive interdisciplinary pain rehabilitation approach may be necessary.
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