Psychosocial factors—including fear of movement and anxiety about the future—are an expected and normal part of LBP experiences.
Low back pain (LBP) interventions are often categorized as “physical” or
“psychological,” creating a potential barrier to recovery in some patients who may be inhibited by these psychosocial factors. An article published in the British Journal of Sports Medicine challenges this separation, stating that understanding and addressing psychosocial factors in clinical practice can help better optimize patient management.
In the research, O’Keeffe et al investigated how psychosocial factors do not always indicate mental health disorders and are not distinct from biological factors. Reductions in pain and disability after treatment are, to some degree, facilitated by changes in non-physical factors, like self-efficacy. For example, exposure to a specific movement that the patient fears paired with an empowering narrative from the provider can reduce the associated fear or anxiety.
The study also argued that psychosocial factors do not only appear in persistent pain presentations. In fact, the authors, who included Steven Z. George, PT, PhD, FAPTA, a member of MedRisk’s International Scientific Advisory Board (ISAB), said that psychosocial factors are an expected and normal part of LBP experiences, acute or chronic.
Psychosocial factors may be just as important to consider as “other factors” when a patient “fails” during “normal” treatment. Exploring and addressing these factors at the front end will ultimately drive more successful patient outcomes. This research supports MedRisk’s PTConsult, a service that makes adjusters aware of any psychosocial factors and provides patient education on the importance of physical therapy, treatment expectations and any perceived barriers to recovery (including anxiety).
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