Twenty-five years with the biopsychosocial model of low back pain—is it time to celebrate? A report from the Twelfth International Forum for Primary Care Research on Low Back Pain
Abstract
Study design An integrated review of current knowledge about the biopsychosocial model of back pain for understanding etiology, prognosis, and interventions, as presented at the plenary sessions of the XII International Forum on LBP Research in Primary Care (Denmark; October 17-19, 2012). Objective To evaluate the utility of the model in reference to rising rates of back pain-related disability, by identifying (a) the most promising avenues for future research in biological, psychological, and social approaches, (b) promising combinations of all 3 approaches, and (c) obstacles to effective implementation of biopsychosocial-based research and clinical practice. Summary of background data The biopsychosocial model of back pain has become a dominant model in the conceptualization of the etiology and prognosis of back pain, and has led to the development and testing of many interventions. Despite this back pain remains a leading source of disability worldwide. Methods The review is a synthesis based on the plenary sessions and discussions at the XII International Forum on LBP Research in Primary Care. The presentations included evidence-based reviews of the current state of knowledge in each of the 3 areas (biological, psychological, and social), identification of obstacles to effective implementation and missed opportunities, and identification of the most promising paths for future research. Results Although there is good evidence for the role of biological, psychological, and…
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Chronic pain is widely recognized as a condition characterized by the complex interaction of biological, psychological, and social factors.
“Chronic pain is widely recognized as a condition characterized by the complex interaction of biological, psychological, and social factors [5–7].”
From Feasibility and Acceptability of an Abbreviated, Four-Week Mindfulness Program for Chronic Pain Management. (2020) · cites this paper as [6]
Cites
Murray, C. J. L., Vos, T., Lozano, R., Naghavi, M., Flaxman, A. D., Michaud, C., Ezzati, M., Shibuya, K., Salomon, J. A., Abdalla, S., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61689-4 · Cited by 8,888 · see citing works
The biopsychosocial approach to chronic pain: Scientific advances and future directions.
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.4.581 · Cited by 3,392 · see citing works
Psychological therapies for the management of chronic pain (excluding headache) in adults
Williams, A. C. D. C., Eccleston, C., & Morley, S. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007407.pub3 · Cited by 1,634 · see citing works
Pincus, T., Burton, A. K., Vogel, S., & Field, A. P. (2002) · Spine · doi:10.1097/00007632-200203010-00017 · Cited by 1,633 · see citing works
Self-citationChronic back pain is associated with decreased prefrontal and thalamic gray matter density
Apkarian, A. V., Sosa, Y., Sonty, S., Levy, R. M., Harden, R. N., Parrish, T. B., & Gitelman, D. R. (2004) · The Journal of Neuroscience · doi:10.1523/jneurosci.2541-04.2004 · Cited by 1,434 · see citing works
Hill, J. C., Whitehurst, D. G., Lewis, M., Bryan, S., Dunn, K. M., Foster, N. E., Konstantinou, K., Main, C. J., Mason, E., Somerville, S., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60937-9 · Cited by 1,306 · see citing works
Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome
Kaptchuk, T. J., Kelley, J. M., Conboy, L. A., Davis, R. B., Kerr, C. E., Jacobson, E. E., Kirsch, I., Schyner, R. N., Nam, B. H., Nguyen, L. T., et al. (2008) · BMJ · doi:10.1136/bmj.39524.439618.25 · Cited by 1,196 · see citing works
Nicholas, M. K., Linton, S. J., Watson, P. J., & Main, C. J. (2011) · Physical Therapy · doi:10.2522/ptj.20100224 · Cited by 690 · see citing works
Disability Prevention: New Paradigm for the Management of Occupational Back Pain
Loisel, P., Durand, M.-J., Berthelette, D., V??zina, N., Baril, R., Gagnon, D., Larivi??re, C., & Tremblay, C. (2001) · Disease Management and Health Outcomes · doi:10.2165/00115677-200109070-00001 · Cited by 339 · see citing works
Self-citationCarroll, C., Rick, J., Pilgrim, H., Cameron, J., & Hillage, J. (2010) · Disability and Rehabilitation · doi:10.3109/09638280903186301 · Cited by 214 · see citing works
Pincus, T., Santos, R., Breen, A., Burton, A. K., & Underwood, M. (2008) · Arthritis Care & Research · doi:10.1002/art.23251 · Cited by 123 · see citing works
Self-citationImmediate effects of a brief mindfulness-based body scan on patients with chronic pain
Ussher, M., Spatz, A., Copland, C., Nicolaou, A., Cargill, A., Amini-Tabrizi, N., & McCracken, L. M. (2014) · Journal of Behavioral Medicine · doi:10.1007/s10865-012-9466-5 · Cited by 122 · see citing works
McCracken, L. M., Gutiérrez-Martínez, O., & Smyth, C. (2013) · Health Psychology · doi:10.1037/a0028093 · Cited by 87 · see citing works
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Sorted by citations
Ardern, C. L., Glasgow, P., Schneiders, A., Witvrouw, E., Clarsen, B., Cools, A., Gojanovic, B., Griffin, S., Khan, K. M., Moksnes, H., et al. (2016) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096278 · Cited by 985 · see citing works
The role of psychosocial processes in the development and maintenance of chronic pain
Edwards, R. R., Dworkin, R. H., Sullivan, M. D., Turk, D. C., & Wasan, A. D. (2016) · The Journal of Pain · doi:10.1016/j.jpain.2016.01.001 · Cited by 954 · see citing works
Core outcome measurement instruments for clinical trials in nonspecific low back pain
Chiarotto, A., Boers, M., Deyo, R. A., Buchbinder, R., Corbin, T. P., Costa, L. O. P., Foster, N. E., Grotle, M., Koes, B. W., Kovacs, F. M., et al. (2018) · Pain · doi:10.1097/j.pain.0000000000001117 · Cited by 461 · see citing works
Core outcome-domains for clinical trials in non-specific low back pain
Chiarotto, A., Deyo, R. A., Terwee, C. B., Boers, M., Buchbinder, R., Corbin, T. P., Costa, L. O. P., Foster, N. E., Grotle, M., Koes, B. W., et al. (2015) · European Spine Journal · doi:10.1007/s00586-015-3892-3 · Cited by 374 · see citing works
Holopainen, R., Simpson, P., Piirainen, A., Karppinen, J., Schütze, R., Smith, A., O'Sullivan, P., & Kent, P. (2020) · Pain · doi:10.1097/j.pain.0000000000001809 · Cited by 180 · see citing works
Self-citationMinimal Clinically Important Difference in Quality of Life for Patients With Low Back Pain
Díaz-Arribas, M. J., Fernández-Serrano, M., Royuela, A., Kovacs, F. M., Gallego-Izquierdo, T., Ramos-Sánchez, M., Llorca-Palomera, R., Pardo-Hervás, P., & Martín-Pariente, O. S. (2017) · Spine · doi:10.1097/brs.0000000000002298 · Cited by 184 · see citing works
A brief summary of pilot and feasibility studies: Exploring terminology, aims, and methods
Donald, G. (2018) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2018.10.017 · Cited by 53 · see citing works
Living well with chronic pain: a classical grounded theory
Lennox Thompson, B., Gage, J., & Kirk, R. (2020) · Disability and Rehabilitation · doi:10.1080/09638288.2018.1517195 · Cited by 53 · see citing works
Fryer, G. (2017) · International journal of osteopathic medicine · doi:10.1016/j.ijosm.2017.05.002 · Cited by 53 · see citing works
Soziale Ungleichheit und chronische Rückenschmerzen bei Erwachsenen in Deutschland
Kuntz, B., Hoebel, J., Fuchs, J., Neuhauser, H., & Lampert, T. (2017) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-017-2568-z · Cited by 37 · see citing works
Understanding and managing pelvic girdle pain from a person-centred biopsychosocial perspective
Beales, D., Slater, H., Palsson, T., & O'Sullivan, P. (2020) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2020.102152 · Cited by 36 · see citing works
Brintz, C. E., Roth, I., Faurot, K., Rao, S., & Gaylord, S. A. (2020) · Pain Medicine · doi:10.1093/pm/pnaa208 · Cited by 30 · see citing works
Pain-related psychological issues in hand therapy
Hamasaki, T., Pelletier, R., Bourbonnais, D., Harris, P., & Choinière, M. (2018) · Journal of Hand Therapy · doi:10.1016/j.jht.2017.12.009 · Cited by 28 · see citing works
Kuhnow, A., Kuhnow, J., Ham, D., & Rosedale, R. (2021) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2019.1710881 · Cited by 17 · see citing works
Biobehavioral Assessments in BACPAC: Recommendations, Rationale, and Methods
Greco, C. M., Wasan, A. D., Schneider, M. J., Mehling, W., Williams, D. A., Darwin, J., & Harte, S. E. (2023) · Pain Medicine · doi:10.1093/pm/pnac175 · Cited by 13 · see citing works
- Authors
- Pincus, T., Kent, P., Bronfort, G., Loisel, P., Pransky, G., & Hartvigsen, J.
- Affiliations
- Northwestern Health Sciences University (US)
- University of Southern Denmark (DK)
- University of Toronto (CA)
- Nordisk Institut for Kiropraktik og Klinisk Biomekanik (DK)
- Corresponding author
- Pincus, Tamar
- Pransky, Glenn
- Venue
- Spine
- Published
- 2013-11
- Volume
- 38
- Issue
- 24
- Pages
- 2118-2123
- ISSN
- 0362-2436 (ISSN-L)
- OpenAlex
- W2313370883
- Cited by
- 227
- References
- 13
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 17 · 2023: 17 · 2022: 17 · 2021: 21 · 2020: 25 · 2019: 13 · 2018: 18 · 2017: 27 · 2016: 20 · 2015: 16 · 2014: 8 · 2013: 1
- FWCI
- 11.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Spine (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Keywords
- biopsychosocial model, low back pain, back pain etiology, psychological factors, social factors, biological factors, implementation barriers, primary care
- MeSH terms
- Humans, Models, Psychological, Prognosis, Review Literature as Topic, Social Behavior, Low Back Pain, Evidence-Based Medicine, Biomedical Research
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