Assessment and Treatment of Patients Presenting with Low Back Pain and Accompanying Psychological Distress: An evidence-based approach

Abstract

Summary Background and Methods It has been suggested that psychological distress is important in the aetiology of low back pain disability, and that in some patients psychological distress becomes the main management problem. Physiotherapy, where the emphasis is on patho-physiological aspects of back pain, has been shown to be less effective in patients with high levels of psychological distress, perhaps because little attention is paid to the distress. A single cohort audit was designed to test the hypothesis that a treatment programme including attention to psychosocial factors could be effective for patients presenting with low back pain and psychological distress. Twenty-five patients referred with a diagnosis of low back, or low back and leg pain and classified as psychologically distressed were enrolled on a pain management type programme which included both psychological and physical intervention. Results Significant improvement occurred in measures of disability, self efficacy and depression. Conclusions In low back pain patients assessment of physical and psychosocial aspects is necessary to aid best treatment choice.