Article

Twenty-five years with the biopsychosocial model of low back pain - is it time to celebrate? A report from the Twelfth International Forum for Primary Care Research on Low Back Pain.

aDepartment of Psychology, Royal Holloway, University of London, England, UK. bResearch Department, Spine Centre of Southern Denmark, Institute of Regional Health Services Research, Hospital Lillebaelt, University of Southern Denmark, Middelfart, Denmark cMusculoskeletal Research Program, Northwestern Health Sciences University, Minnesota, USA dNordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark eDalla Lana School of Public Health, University of Toronto, Toronto, Canada fCanadian Memorial Chiropractic College, Toronto, Canada gLiberty Mutual Research Institute for Safety, Hopkinton, Massachusetts, USA hDepartment of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester Massachusetts, USA iHarvard School of Public Health, Boston, USA jInstitute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Spine (Impact Factor: 2.45). 08/2013; DOI: 10.1097/BRS.0b013e3182a8c5d6
Source: PubMed

ABSTRACT Study Design. An integrated review of current knowledge about the biopsychosocial model of back pain for understanding aetiology, prognosis and interventions, as presented at the plenary sessions of theXII International Forum on LBP Research in Primary Care (Denmark 17-19 October 2012).Objective. To evaluate the utility of the model in reference to rising rates of back pain related disability, by identifying a) the most promising avenues for future research in biological, psychological and social approaches, b) promising combinations of all three approaches and c) obstacles to effective implementation of biopsychosocial based research and clinical practice.Summary of Background Data. The biopsychosocial model of back pain has become a dominant model in the conceptualisation of the aetiology and prognosis of back pain, and has led to the development and testing of many interventions. Despite this back pain remains a leading source of disability worldwide.Methods. The review is a synthesis based on the plenary sessions and discussions at the XII International Forum on LBP Research in Primary Care. The presentations included evidence-based reviews of the current state of knowledge in each of the three areas (biological, psychological and social), identification of obstacles to effective implementation and missed opportunities, and identification of the most promising paths for future research.Results. While there is good evidence for the role of biological, psychological and social factors in the aetiology and prognosis of back pain, synthesis of the three in research and clinical practice has been suboptimal.Conclusion. The utility of the biopsychosocial framework cannot be fully assessed until we truly adopt and apply it in research and clinical practice.

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