An Early Biopsychosocial Intervention Design for the Prevention of Low Back Pain Chronicity: A Multidisciplinary Empirical Approach

Abstract

Objective: Comprehensive intervention models for prevention of chronification of low back pain, in which the early identification of holistic risk factors is considered are needed. The aim of this study is to design a tailored biopsychosocial intervention for patients with low back pain to prevent pain chronicity. Design: A multidisciplinary empirical approach. Methods: A multidisciplinary team designed a biopsychosocial intervention following an application from the Medical Research Council’s complex intervention framework. The methods used included problem identification, identification of the evidence, theory, and needs, examination of the current context and modelling of the theory. Biomechanical, psychological, social and environmental, and lifestyle and personal risk factors were taken into account. Results: The intervention process was introduced in a logic model. The model presents all the required resources, their activities and outputs, as well as the outcomes and impacts of the intervention. The intervention was tailored according to the underlying risk factors for pain chronification in patients with low back pain. Conclusion: A comprehensive tailored intervention may decrease the risk of pain chronicity. Further studies are needed to obtain information on the feasibility, effectiveness and cost-effectiveness of such interventions. LAY ABSTRACT Low back pain is the leading cause of years lived with disability worldwide. In cases of non-specific low back pain, a specific structural reason for the pain cannot be identified. It is recognized, however, that individual factors, such as biomechanical, psychological, social, environmental, lifestyle, and personal factors, can increase the risk of pain chronicity. Therefore, a multidisciplinary intervention was designed to address these individual factors in addition to traditional treatment methods. The intervention was also designed to improve the timing of the rehabilitation to prevent pain chronification. This study presents the background, the different phases of the design process, and the model for the intervention. Further studies will be conducted to determine the applicability and effectiveness of the design.

Keywords

• low back pain
• chronic pain
• biopsychosocial model
• rehabilitation
• multidisciplinary research