Consider Psychosocial Aspects of Low Back PainLooking at the social side of patient's with chronic low back pain (LBP) has changed how we treat this problem. Experts agree that patients with chronic LBP who have difficult or complex social and psychologic factors in their lives may need a different approach than those who don't.
This model is called the biopsychosocial model of spine care. It is the topic of this article with the goal of bringing us up to date on the subject. Although this model has been useful in managing patients with chronic LBP, there are still some concerns about it.
First, using this model may overemphasize the social aspects and under treat the spine. Second, it is still a theory and needs further evidence to support its use. Third, do we really know if using the biopsychosocial model results in better outcomes than other treatment approaches?
And finally, does this model, which uses a multidisciplinary approach, lead to increasing medical costs? Spine specialists, physical therapists, chiropractors, massage therapists, and behavioral counselors are just the short list of health care providers who are involved. And pain management specialists of all kinds may be added in as well.
Results of the first studies on the biopsychosocial approach to chronic LBP are just now being published. Patients report better results with this approach compared to standard care. But whether the results last and at what price remains to be determined.
The author suggests a continued close look at how this approach has changed health care for chronic LBP patients. We must be careful not to fall into the trap of using the wrong measures to examine outcomes of treatments.
Bradley K. Weiner, MD. Spine Update. The Biopsychosocial Model and Spine Care. In Spine. January 15, 2008. Vol. 33. No. 2. Pp. 219-223.
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