Biopsychosocial factors have a very strong influence on the course if back pain related disability and work absence. A simplistic view would suggest that tackling any of the most potent factors should improve prognosis, leading to reduced insurance outlay.
Karjakainen K, et al (Cochrane Back Review Group), Spine (2001), Vol. 26 #3, p.262-9.
Review of research into multidisciplinary biopsychosocial (MBP) rehabilitation for sub-acute low back
pain (LBP) in working-age adults.
The authors state that there is moderate evidence showing MBP for sub-acute LBP is effective.
Such a wide range of inhomogeneous studies examined therefore would be very hard to compare properly. This area is lacking in well designed studies.
LBP is a leading cause of morbidity in the working age population and is often linked with negligence. While the validity of this link is disputed, the need to get people back to work is not. Active rehabilitation is considered to be the best approach, but evidence of an effective approach is still hard to come by.
A high quality review of occupational low back pain by Prof. G Waddell and Prof. K Burton is available from the Faculty of Occupational Medicine £15. This review and guidance were project-managed by Andrew Auty on behalf of the British Occupational Health Research Foundation and Blue Circle Industries.
Van Tulder MW, et al (Cochrane Back Review Group), Spine (2001) 26#3, 270-81
Review of research into behavioural treatment for chronic low back pain.
Behavioural treatment appears to be an effective treatment for patients with chronic LBP, but consistent methods matching patient and behaviour are unknown.
Behavioural treatment is likely to be much less expensive than the more multidisciplinary approaches. More studies are under way.