Psychosocial issues: Their importance in predicting disability, response to treatment, and search for compensation

As we have reviewed, the conceptualization of pain and its progression into chronic disability has evolved from unidimensional models to more integrative, biopsychosocial models that take into account the many biological, psychological, social, and economic factors that may significantly contribute to the pain experience in any given individual. The traditional, overly simplistic biomedical explanation or model has been abandoned. It has been replaced with the acceptance of the need to take into account the multitude of physiologic and psychosocioeconomic variables that are intertwined and ultimately produce the pain experience. We have reviewed various studies that have demonstrated our growing understanding of these complex, interactive processes in helping to predict those who develop chronic disability, as well as those who respond best to treatment attempts. We have also reviewed the importance of better understanding the issue of compensation and how this factor is also intricately intertwined with the other variables in further understanding the complex and the interactive processes involved in LBP. There is currently no doubt that a multidimensional approach has become commonly accepted among researchers in the field of LBP. Clinical and research efforts need to continue to incorporate the better understanding of biological and psychosocioeconomic aspects of pain. Such understanding will not only help clinicians in their efforts to treat LBP patients effectively, but it will also ultimately save great economic and emotional costs through the development of more efficacious treatment of LBP disability.