Psychological factors and treatment opportunities in low back pain
Psychological factors and treatment opportunities in low back pain
A large body of evidence suggests that psychological factors, including emotions, beliefs and avoidant behaviours, are linked to poor outcomes in low back pain. At the same time, the evidence from trials of psychological interventions suggests that they improve outcomes mostly in the short term and against passive controls only. These suboptimal results may be due to low competency or fidelity in delivery, or inadequate matching of treatment methods with specific patient problems. Most importantly, there is insufficient theoretical guidance and integration in the design, selection and delivery of methods that precisely target known process of pathology. We identify several new directions for research and opportunities to improve the impact of psychological interventions and to change clinical practice. These include better ways to conceptualise and deliver reassurance at early stages of back pain, utilising models such as the psychological flexibility model to guide treatment development, and essentially extend the fear-avoidance model.
625-635
Pincus, Tamar
55388347-5d71-4fc0-9fd2-66fbba080e0c
McCracken, Lance M
74d60243-8025-4ac5-8c7b-b93bf8a87089
October 2013
Pincus, Tamar
55388347-5d71-4fc0-9fd2-66fbba080e0c
McCracken, Lance M
74d60243-8025-4ac5-8c7b-b93bf8a87089
Pincus, Tamar and McCracken, Lance M
(2013)
Psychological factors and treatment opportunities in low back pain.
Best Practice and Research. Clinical Rheumatology, 27 (5), .
(doi:10.1016/j.berh.2013.09.010).
Abstract
A large body of evidence suggests that psychological factors, including emotions, beliefs and avoidant behaviours, are linked to poor outcomes in low back pain. At the same time, the evidence from trials of psychological interventions suggests that they improve outcomes mostly in the short term and against passive controls only. These suboptimal results may be due to low competency or fidelity in delivery, or inadequate matching of treatment methods with specific patient problems. Most importantly, there is insufficient theoretical guidance and integration in the design, selection and delivery of methods that precisely target known process of pathology. We identify several new directions for research and opportunities to improve the impact of psychological interventions and to change clinical practice. These include better ways to conceptualise and deliver reassurance at early stages of back pain, utilising models such as the psychological flexibility model to guide treatment development, and essentially extend the fear-avoidance model.
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Published date: October 2013
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Copyright © 2013 Elsevier Ltd. All rights reserved.
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Local EPrints ID: 469235
URI: http://eprints.soton.ac.uk/id/eprint/469235
ISSN: 1532-1770
PURE UUID: 941b6345-6728-40f8-8888-68b84f33a6f7
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Date deposited: 09 Sep 2022 16:47
Last modified: 17 Mar 2024 04:11
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Author:
Tamar Pincus
Author:
Lance M McCracken
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