PSYCHOSOCIAL FACTORS IN DISABLING LOW-BACK-PAIN - CAUSES OR CONSEQUENCES

Low back pain (LBP) is a common problem that is costly in both financi al and human terms. The impact of LBP on an individual varies greatly. For some, LBP is a minor inconvenience; but for others LBP is associa ted with significant disability and with psychosocial dysfunction for the individual and for the family. Whether psychosocial factors are ca uses or consequences has been the subject of debate. This paper is a r eview of psychosocial factors associated with disabling LBP. It addres ses the question of whether these factors are causes or consequences o f the disability due to LBP. Based on this review it was concluded tha t there is little evidence in support of the concept of a pain-prone p ersonality. Once LBP has occurred, the impact of the LBP on the indivi dual and the family is influenced by the health-beliefs and coping str ategies of the individual and the family. Distress appears to be secon dary to physical restriction rather than pain, but the distress may ag gravate the pain and thus the disability. The paper concludes with a d iscussion of the impact of health practitioners on pain-related disabi lity.