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Chiropractic Research Review

Addressing Psychosocial Issues in Back Pain

In recent years there has been a shift in the assessment and management of low back pain. This approach, known as the "psychobiosocial model," incorporates a broader view of the circumstances involved in patients' perceptions of pain and dysfunction to include physical, psychological and social components.

This review of the literature provides an overview of the biopsychosocial model as it relates to low back pain. Specific methods of patient education and activation are discussed, including:

* the role of the clinician as guide and facilitator to help patients return to full function;

* identification of illness behaviors;

* activating patient compliance and motivating patients;

* implementation of exercise quotas to set goals for patient management; and

* the use of behavior reinforcers.

The author asserts that biopsychosocial strategies fall within the philosophic models of prevention and wellness long associated with the chiropractic profession. He suggests that clinicians should include these strategies in their case management protocol, focusing on specific goals aimed at "reducing patient anxiety, promoting activity, and increasing patients ability to be in control of activities of daily living."

Hoffmann B. Confronting psychosocial issues in patients with low back pain. Topics in Clinical Chiropractic, June 1999:6(2), pp1-7.
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Chiropractic Research Review

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