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.