Evidence Review

Diagnostic Triage

Initial Assessment Methods
(Adapted from AHCPR 1994)

X-Rays

Psychosocial Factors

Risk factors for chronicity

Management

Information to Patients

Psychosocial Factors

There is now a great deal of evidence on psychosocial factors in chronic low back pain. Several recent prospective cohort studies show that psychosocial factors are important at a much earlier stage than previously believed.

	Psychological, social and economic factors play an important role in chronic low back pain and disability. Waddell 1992, Waddell & Turk 1992
	Psychosocial factors are important at a much earlier stage than previously believed . Deyo & Diehl 1988, Burton et al 1995, Klenerman et al 1995, Gatchel et al 1995
	Psychosocial factors influence a patient’s response to treatment and rehabilitation. Waddell 1992, Waddell & Turk 1992

Note: the work on psychosocial factors is on going. Materials about assessing psychosocial factors such as Kendall et al 1997: Guide to Assessing Psychosocial Yellow Flags (reproduced in Waddell 1998) are available.