Interventions on psychosocial risk factors in acute or subacute low back pain in primary care: literature review

Background. Chronic low back pain is a frequent problem in general practice. Psychosocial factors are involved in the transition from acute to chronic low back pain. The aim of this review was to identify and to describe the trials dealing with interventions on psychosocial factors in (sub) acute low back pain in primary care, and to analyze their effectiveness. Methods. A systematic review was undertaken through the main biomedical databases and relevant papers were selected. The characteristics of the interventions were described, and the main results analyzed. Results. Out of the 513 studies identified, 10 were selected. All the interventions included an educational approach, often based on a booklet: the Back Book(21). Some assessed additional cognitive-behavioral therapies. Another one was mainly centered on the workplace. In these articles, the description of the interventions and the underlying theories was often insufficient. The impact on the prognosis of the patients was modest. Conclusion. Current guidelines on the management of (sub) acute low back pain in primary care have not yet integrated the results of these studies, but this review provides few arguments to promote the implementation of the interventions identified. More individualized interventions might be another way to improve the prognosis of patients with psychosocial risk factors.