to Assessing Psychosocial Yellow Flags in Acute Low Back Pain: Risk
Factors for Long-Term Disability and Work Loss
Appendix 1: What does ‘Psychosocial’ mean?
The term psychosocial refers to the interaction between the person and their social environment, and the influences on their behaviour.
- The social environment includes
family members, friends, people at work, employers, the compensation
system and health professionals.
- Any of these people have the
potential to affect a person with back pain.
- These interactions may influence
behaviour, levels of distress, attitudes and beliefs and subjective
experiences of pain.
- Even well intentioned actions can
inadvertently result in counterproductive outcomes.
- The biopsychosocial model of back
pain and disability emphasises the interaction between multiple
recurrent, and chronic back pain
Before proceeding to assess
Psychosocial Yellow Flags it is important to differentiate between
acute, recurrent, and chronic presentations. Evidence suggests that
treating chronic back pain as if it were a new episode of acute back
pain can result in perpetuation of disability.
This is especially true if treatment
- rely on a narrow medical model of
pain and emphases short-term palliative care, with no long-term
- discourage self care and fail to
instruct the patient in self management
- sanction disability and don't
provide interventions that will improve function
- over-investigate and perpetuate
belief in the broken part hypothesis