Biopsychosocial determinants of chronic disability and low-back pain: A review

It is well known that the human and financial costs related to sick leave d ue to Low-Back Pain (LBP) are substantial in a small percentage of workers. A better understanding of the predictive factors for chronic disability wo uld allow interventions to be adapted and costs to be reduced. This paper i s a critical review of recent prospective studies on the biopsychosocial fa ctors predictive of nonreturn to work due to LBP. A sample of 18 prospectiv e studies were systematically analyzed. Despite the limited number of prosp ective studies and their differences, some factors are promising indicators , These include a previous history of LBP results of certain clinical rests , a subjective negative appraisal of one's ability to work, and job dissati sfaction. The role of certain psychological variables, including attitudes and beliefs, as well as coping strategies, is also emerging. Additional stu dies are necessary to confirm the importance of these factors, to specify t he nature of the interrelationships among them, and to integrate them into a conceptual framework.