title: Interventions focusing on psychosocial risk factors for patients with non-chronic low back pain in primary care--a systematic review.
abstract: BACKGROUND
  Low back pain (LBP) is a problem that is frequently encountered in primary care, and current guidelines encourage care providers to take into account psychosocial risk factors in order to avoid transition from acute to chronic LBP.
  
  
  OBJECTIVE
  To review the effectiveness of interventions focusing on psychosocial risk factors for patients with non-chronic LBP in primary care.
  
  
  METHODS
  A systematic search was undertaken for controlled trials focusing on psychosocial factors in adult patients with non-chronic, non-specific LBP in primary care by exploring Medline, Embase, PsycInfo, Francis, Web of Sciences and The Cochrane Library. The methodological quality of the studies included was assessed before analysing their findings.
  
  
  RESULTS
  Thirteen studies were selected, seven being considered as having a low risk of bias. Information strategies were assessed by eight trials, with high-quality evidence of no effectiveness for pain, function, work issues and health care use, low-quality evidence of no effectiveness for self-rated overall improvement, satisfaction and pain beliefs and lack of evidence in terms of quality of life. Cognitive behavioural therapy was assessed by three trials, with very low-quality evidence of moderate effectiveness for pain, function, quality of life, work issues and health care use. There was lack of evidence concerning the effectiveness of individual and group education intervention or work coordination.
  
  
  CONCLUSIONS
  Among the wide range of psychosocial risk factors, research has focused mainly on pain beliefs and coping skills, with disappointing results. Extended theoretical models integrating several psychosocial factors and multicomponent interventions are probably required to meet the challenge of LBP.
authors.affiliation: Department of General Practice and Laboratory of Ergonomics and Epidemiology in Occupational Health, University of Angers, PRES L'UNAM, Angers and Aline.ramond@univ-angers.fr.
authors.forename: Aline
authors.initials: A
authors.lastname: Ramond-Roquin
authors.affiliation: Department of General Practice and Laboratory of Ergonomics and Epidemiology in Occupational Health, University of Angers, PRES L'UNAM, Angers and.
authors.forename: Céline
authors.initials: C
authors.lastname: Bouton
authors.affiliation: Department of General Practice and.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Gobin-Tempereau
authors.affiliation: Laboratory of Ergonomics and Epidemiology in Occupational Health, University of Angers, PRES L'UNAM, Angers and.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Airagnes
authors.affiliation: Laboratory of Ergonomics and Epidemiology in Occupational Health, University of Angers, PRES L'UNAM, Angers and Regional Center for Rehabilitation of Angers and.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Richard
authors.affiliation: Laboratory of Ergonomics and Epidemiology in Occupational Health, University of Angers, PRES L'UNAM, Angers and Department of Occupational Health, University Hospital of Angers, Angers, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Roquelaure
authors.affiliation: Department of General Practice and Laboratory of Ergonomics and Epidemiology in Occupational Health, University of Angers, PRES L'UNAM, Angers and.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Huez
mesh_terms: D006801:Humans; D017116:Low Back Pain / Q000523:psychology* / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care; D011788:Quality of Life; D012307:Risk Factors; D013315:Stress, Psychological / Q000517:prevention & control*
keywords: Intervention studies; low back pain; primary health care; psychology; review[publication type]; treatment outcome.