A bio-psycho-social approach for treating sub-acute low back pain.
OBJECTIVE
This article examines the distinctive opportunities and challenges involved in treating sub-acute low back pain (LBP). Several risk factors have been identified. Thus, a multi-disciplinary design and a comprehensive bio-psycho-social approach seem to be the best modality of intervention to improve outcome.


METHODS
The relevant literature on various factors that are supposed to improve outcome is summarised and discussed.


RESULTS
A controversial on the rehabilitation benefits still exists. From one side, meta-analytic studies provide a small evidence of effectiveness. Most treatments for chronic LBP provide weak results and the benefits can be just transient. From the other side, comprehensive bio-psycho-social approaches seem to be the best modality of intervention to facilitate physical outcome and return to work.


CONCLUSIONS
This article reflects the conviction that clinicians with a special knowledge on LBP problems and researchers with a special knowledge on health policy will better work together. Their targets are outcome and cost-benefit ratio by taking into account the economical and political milieu of the country where the research is carried out.
Giaquinto
Salvatore
S
IRCCS Rehabilitation Institute San Raffaele Pisana, Rome I-00163, Italy. salvatore.giaquinto@sanraffaele.it
Bruti
Loredana
L
Dall'Armi
Valentina
V
Gison
Annalisa
A
Palma
Enzo
E
D000208:Acute Disease; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D006801:Humans; D017116:Low Back Pain / Q000523:psychology* / Q000534:rehabilitation*; D016032:Randomized Controlled Trials as Topic; D012931:Social Environment; D012944:Social Support; D016896:Treatment Outcome; D017132:Workplace