A narrative review on non-specific low back pain and return to work; Biomechanical and psychosocial influences

Item

Title
A narrative review on non-specific low back pain and return to work; Biomechanical and psychosocial influences
Title
A narrative review on non-specific low back pain and return to work; Biomechanical and psychosocial influences
Author(s)
Collins John
Abstract
Objectives: The purpose of this narrative review was to assess the methodological quality of existing research to the extent that biomechanical and psychosocial factors (especially fear avoidance, recovery expectations, anxiety and depression) affect the prognostic outcome of return to work in non-specific low back pain (NSLBP) & how such information can inform osteopathy. Methods: A range of papers of varying hierarchical validity from the last 10 years were sourced from online and hand searches. Papers were divided into groups, appraised using established assessment criteria and ranked in order of quality. Results: 24 papers met the inclusion criteria. Quality varied, with only 9 papers receiving good appraisals. Sufficient methodologically strong evidence was found to suggest that expectation of patient or practitioner recovery expectation is predictive of work outcome and that to a lesser extent depression and anxiety are predictive of work outcome. There is moderate evidence that fear avoidance beliefs are predictive of work outcome and that biomechanical considerations may be related to the first onset of low back pain. There is little evidence that secondary control, based solely on these principles, influences risk of recurrence or progression to chronic disability and it is not predictive of work outcome. Conclusions: To predict work outcome in NSLBP, psychosocial assessment should focus on patients recovery expectations, fear avoidance and distress/depression. More research is needed to determine the best method of measuring these constructs and to determine how to intervene when a worker has low recovery expectations. Future studies could clarify the relationships between distress/depression, fear avoidance and low back pain using high quality randomized controlled studies.
Abstract
Objectives: The purpose of this narrative review was to assess the methodological quality of existing research to the extent that biomechanical and psychosocial factors (especially fear avoidance, recovery expectations, anxiety and depression) affect the prognostic outcome of return to work in non-specific low back pain (NSLBP) & how such information can inform osteopathy. Methods: A range of papers of varying hierarchical validity from the last 10 years were sourced from online and hand searches. Papers were divided into groups, appraised using established assessment criteria and ranked in order of quality. Results: 24 papers met the inclusion criteria. Quality varied, with only 9 papers receiving good appraisals. Sufficient methodologically strong evidence was found to suggest that expectation of patient or practitioner recovery expectation is predictive of work outcome and that to a lesser extent depression and anxiety are predictive of work outcome. There is moderate evidence that fear avoidance beliefs are predictive of work outcome and that biomechanical considerations may be related to the first onset of low back pain. There is little evidence that secondary control, based solely on these principles, influences risk of recurrence or progression to chronic disability and it is not predictive of work outcome. Conclusions: To predict work outcome in NSLBP, psychosocial assessment should focus on patients recovery expectations, fear avoidance and distress/depression. More research is needed to determine the best method of measuring these constructs and to determine how to intervene when a worker has low recovery expectations. Future studies could clarify the relationships between distress/depression, fear avoidance and low back pain using high quality randomized controlled studies.
presented at
British School of Osteopathy
Date Accepted
2011
Date Submitted
3.2.2012 00:00:00
Type
osteo_thesis
Language
English
Pub-Identifier
15047
Inst-Identifier
780
Recommended
0
Item sets
Thesis

Collins John, “A narrative review on non-specific low back pain and return to work; Biomechanical and psychosocial influences”, Osteopathic Research Web, accessed April 22, 2025, https://library.wso.at/s/orw/item/1789