BackgroundLower back pain (LBP) is a leading global burden, causing the greatest global disability of any condition (Vos et al., ). The mean lifetime prevalence of LBP is estimated at 38.9% globally, with increased rates in older populations (Hoy et al., ). Chronic lower back pain (CLBP) forms the largest portion of this social and economic burden, being associated with higher insurance claims (Gore et al., ), increased time off work (Maetzel and Li, ; Steenstra et al., ), higher medical and pharmaceutical costs (Dagenais et al., ), as well as a higher number of comorbidities, such as anxiety, depression and sleep disorders (Gore et al., ). Lower back pain is not a disease entity but rather a symptom of illness, with a complex array of potential biological, psychological and sociological contributing factors (Gatchel et al., ).The biopsychosocial model, made prominent by Gordon Waddell in 1987, is currently the recommended model for understanding and managing LBP and its resulting disability (Waddell, ; Gatchel et al., ; Pincus et al., ; IASP, ). Biological mechanisms are critical in understanding pain and disability (the ‘bio’ in biopsychosocial) (Hancock et al., ); however, the last three decades have seen considerable efforts to further understand the role of psychosocial factors (Hancock et al., ;
European Journal of Pain – Wiley
Published: Jan 1, 2018
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