Psychologically Informed Interventions for Low Back Pain: An Update for Physical Therapists

Nicholas, Michael K.; George, Steven Z.

doi:10.2522/ptj.20100278

Cited by 139Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationPain Management and Treatment

Psychologically Informed Interventions for Low Back Pain: An Update for Physical Therapists

Nicholas, Michael K., George, Steven Z.·2011·Physical Therapy

DOI 10.2522/ptj.20100278

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Abstract

A central theme of current evidence-based guidelines for managing low back pain is endorsement of the resumption of activities despite the presence of pain. This task can be challenging for both therapists and patients, and there are many essentially psychological obstacles to implementing the guidelines. These obstacles can be overcome by knowing how to recognize potential psychological obstacles and understanding the options for managing psychological obstacles in combination with activity-based interventions. This article is intended to address these tasks by explaining and describing the application of empirically based psychological principles and strategic clinical reasoning. Importantly, the roles of skills in assessment, treatment planning, and communication with patients are identified as essential but feasible skills for physical therapists to acquire with appropriate training.

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Psychologically informed physical therapy programs help physical therapists integrate emotional and cognitive components of care and are advantageous to implementation of interdisciplinary programs.
“The development of psychologically informed physical therapy (PiPT) programs help physical therapists integrate emotional/cognitive components of care and is advantageous to implementation of interdisciplinary programs.22,29-31”
From Remotely Delivered Psychologically Informed Mindful Movement Physical Therapy for Pain Care: A Framework for Operationalization (2023) · cites this paper as [30]

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Fear-avoidance model of chronic musculoskeletal pain: 12 years on
Vlaeyen, J. W. S., & Linton, S. J. (2012) · Pain · doi:10.1016/j.pain.2011.12.009 · Cited by 1,281 · see citing works
Low back pain
Vlaeyen, J. W. S., Maher, C. G., Wiech, K., Van Zundert, J., Meloto, C. B., Diatchenko, L., Battié, M. C., Goossens, M., Koes, B., & Linton, S. J. (2018) · Nature Reviews Disease Primers · doi:10.1038/s41572-018-0052-1 · Cited by 497 · see citing works
Psychologically Informed Practice for Management of Low Back Pain: Future Directions in Practice and Research
Main, C. J., & George, S. Z. (2011) · Physical Therapy · doi:10.2522/ptj.20110060 · Cited by 306 · see citing works
Self-citation
Untitled work
Bunzli (2013) · doi:10.1097/ajp.0b013e31827a6dd8 · Cited by 199 · see citing works
International Olympic Committee consensus statement on pain management in elite athletes
Hainline, B. W., Derman, W. E., Vernec, A. R., Budgett, R., Deie, M., Dvořák, J., Harle, C. A., Herring, S. A., McNamee, M., Meeuwisse, W. H., et al. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-097884 · Cited by 198 · see citing works
Advancing Psychologically Informed Practice for Patients With Persistent Musculoskeletal Pain: Promise, Pitfalls, and Solutions
Keefe, F. J., Main, C. J., & George, S. Z. (2018) · Physical Therapy · doi:10.1093/ptj/pzy024 · Cited by 180 · see citing works
Self-citation
Development of a Yellow Flag Assessment Tool for Orthopaedic Physical Therapists: Results From the Optimal Screening for Prediction of Referral and Outcome (OSPRO) Cohort
Lentz, T. A., Beneciuk, J. M., Bialosky, J. E., Zeppieri, G., Dai, Y., Wu, S. S., & George, S. Z. (2016) · Journal of Orthopaedic & Sports Physical Therapy · doi:10.2519/jospt.2016.6487 · Cited by 137 · see citing works
Self-citation
Rehabilitation management of low back pain – it’s time to pull it all together!
Tousignant‐Laflamme, Y., Martel, M. O., Joshi, A. B., & Cook, C. (2017) · Journal of Pain Research · doi:10.2147/jpr.s146485 · Cited by 126 · see citing works
Psychological predictors of recovery from low back pain: a prospective study
George, S. Z., & Beneciuk, J. M. (2015) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-015-0509-2 · Cited by 104 · see citing works
Self-citation
Physical therapy informed by acceptance and commitment therapy (PACT) versus usual care physical therapy for adults with chronic low back pain: a randomized controlled trial.
Godfrey, E., Wileman, V., Galea Holmes, M., McCracken, L. M., Norton, S., Moss-Morris, R., Noonan, S., Barcellona, M., & Critchley, D. (2020) · The Journal of Pain · doi:10.1016/j.jpain.2019.05.012 · Cited by 91 · see citing works
Physical therapy and migraine: musculoskeletal and balance dysfunctions and their relevance for clinical practice
Carvalho, G. F., Schwarz, A., Szikszay, T. M., Adamczyk, W. M., Bevilaqua‐Grossi, D., & Luedtke, K. (2019) · Brazilian Journal of Physical Therapy · doi:10.1016/j.bjpt.2019.11.001 · Cited by 91 · see citing works
Effectiveness of Therapeutic Patient Education for Adults with Migraine. A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Kindelan-Calvo, P., Gil‐Martínez, A., Paris‐Alemany, A., Pardo-Montero, J., Muñoz‐García, D., Angulo, S., & Touche, R. L. (2014) · Pain Medicine · doi:10.1111/pme.12505 · Cited by 77 · see citing works
Low- Versus High-Intensity Plyometric Exercise During Rehabilitation After Anterior Cruciate Ligament Reconstruction
Chmielewski, T. L., George, S. Z., Tillman, S. M., Moser, M. W., Lentz, T. A., Indelicato, P. A., Trumble, T. N., Shuster, J. J., Cicuttini, F., & Leeuwenburgh, C. (2016) · The American Journal of Sports Medicine · doi:10.1177/0363546515620583 · Cited by 73 · see citing works
Self-citation
A Psychological View of Sexual Pain among Women: Applying the Fear-Avoidance Model
Thomtén, J., & Linton, S. J. (2013) · Women s Health · doi:10.2217/whe.13.19 · Cited by 69 · see citing works
Cognitive exposure versus avoidance in patients with chronic pain: Adherence matters
Nicholas, M. K., Asghari̇, A., Sharpe, L., Brnabic, A. J. M., Wood, B. M., Overton, S., Tonkin, L., Sousa, M. D., Finniss, D. G., Beeston, L., et al. (2013) · European Journal of Pain · doi:10.1002/j.1532-2149.2013.00383.x · Cited by 68 · see citing works
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Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions
Pergolizzi, J. V., & LeQuang, J. A. (2020) · Pain and Therapy · doi:10.1007/s40122-020-00149-5 · Cited by 77 · see citing works
An Interprofessional Consensus of Core Competencies for Prelicensure Education in Pain Management: Curriculum Application for Physical Therapy
Bement, M. H., Marie, B. S., Nordstrom, T. M., Christensen, N., Mongoven, J. M., Koebner, I. J., Fishman, S. M., & Sluka, K. A. (2013) · Physical Therapy · doi:10.2522/ptj.20130346 · Cited by 63 · see citing works
An Interprofessional Consensus of Core Competencies for Prelicensure Education in Pain Management: Curriculum Application for Nursing
Herr, K., Marie, B. S., Gordon, D. B., Paice, J. A., Watt‐Watson, J., Stevens, B., Bakerjian, D., & Young, H. M. (2015) · Journal of Nursing Education · doi:10.3928/01484834-20150515-02 · Cited by 62 · see citing works
The biopsychosocial model of pain in physiotherapy: past, present and future
Smart, K. M. (2023) · Physical Therapy Reviews · doi:10.1080/10833196.2023.2177792 · Cited by 61 · see citing works
Adherence to Back Pain Clinical Practice Guidelines by Brazilian Physical Therapists
de Souza, F. S., Ladeira, C. E., & Costa, L. O. P. (2017) · Spine · doi:10.1097/brs.0000000000002190 · Cited by 57 · see citing works
Kinesiophobia and Its Association With Health-Related Quality of Life Across Injury Locations
Goldberg, P., Zeppieri, G., Bialosky, J. E., Bocchino, C., van den Boogaard, J., Tillman, S. M., & Chmielewski, T. L. (2017) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2017.06.023 · Cited by 53 · see citing works
Reassurance for patients with non-specific conditions – a user's guide
Traeger, A. C., O’Hagan, E. T., Cashin, A. G., & McAuley, J. H. (2017) · Brazilian Journal of Physical Therapy · doi:10.1016/j.bjpt.2016.12.007 · Cited by 50 · see citing works
Development of a Computer-Based Clinical Decision Support Tool for Selecting Appropriate Rehabilitation Interventions for Injured Workers
Gross, D., Zhang, J., Steenstra, I., Barnsley, S., Haws, C., Amell, T., McIntosh, G., Cooper, J. E., & Zaiane, O. R. (2013) · Journal of occupational rehabilitation · doi:10.1007/s10926-013-9430-4 · Cited by 41 · see citing works
Implementation of Psychologically Informed Physical Therapy for Low Back Pain: Where Do We Stand, Where Do We Go?
Ballengee, L. A., Zullig, L. L., & George, S. Z. (2021) · Journal of Pain Research · doi:10.2147/jpr.s311973 · Cited by 46 · see citing works
Self-citation
Cognitive-Behavioral–Based Physical Therapy to Improve Surgical Spine Outcomes: A Case Series
Archer, K. R., Motzny, N., Abraham, C. M., Yaffe, D. M., Seebach, C. L., Devin, C. J., Spengler, D. M., McGirt, M. J., Aaronson, O. S., Cheng, J. S., et al. (2013) · Physical Therapy · doi:10.2522/ptj.20120426 · Cited by 43 · see citing works
Use of Physical Therapy for Low Back Pain by Medicaid Enrollees
Fritz, J. M., Kim, J., Thackeray, A., & Dorius, J. (2015) · Physical Therapy · doi:10.2522/ptj.20150037 · Cited by 43 · see citing works
Relevance of Kinesiophobia in Relation to Changes Over Time Among Patients After an Acute Coronary Artery Disease Event
Bäck, M., Lundberg, M., Cider, Å., Herlitz, J. D., & Jansson, B. (2017) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000265 · Cited by 42 · see citing works
Exploring physiotherapists' experiences of implementing a cognitive behavioural approach for managing low back pain and identifying barriers to long-term implementation
Richmond, H., Hall, A. M., Hansen, Z., Williamson, E. M., Davies, D., & Lamb, S. E. (2017) · Physiotherapy · doi:10.1016/j.physio.2017.03.007 · Cited by 41 · see citing works
Physical therapy clinical specialization and management of red and yellow flags in patients with low back pain in the United States
Ladeira, C. (2018) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2017.1390652 · Cited by 39 · see citing works
Psychological factors in genital pain: The role of fear-avoidance, pain catastrophizing and anxiety sensitivity among women living in Sweden
Thomtén, J., & Karlsson, A. (2014) · Scandinavian Journal of Pain · doi:10.1016/j.sjpain.2014.01.003 · Cited by 36 · see citing works
Reducing the use of opioids by patients with chronic pain: an effectiveness study with long-term follow-up
Nicholas, M. K., Asghari, A., Sharpe, L., Beeston, L., Brooker, C. D., Glare, P. A., Martin, R. M., Molloy, A. R., & Wrigley, P. J. (2019) · Pain · doi:10.1097/j.pain.0000000000001763 · Cited by 35 · see citing works
Self-citation
Management of Pain in Elite Athletes: Identified Gaps in Knowledge and Future Research Directions
Zideman, D. A., Derman, W. E., Hainline, B. W., Moseley, G. L., Orchard, J. W., Pluim, B. M., Siebert, C. H., & Turner, J. A. (2018) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0000000000000618 · Cited by 35 · see citing works
Fear Avoidance and Pain Catastrophizing among Women with Sexual Pain
Thomtén, J., Lundahl, R., Stigenberg, K., & Linton, S. J. (2014) · Women s Health · doi:10.2217/whe.14.51 · Cited by 33 · see citing works
The Global Spine Care Initiative: a narrative review of psychological and social issues in back pain in low- and middle-income communities
Cedraschi, C., Nordin, M. C., Haldeman, S., Randhawa, K. A., Kopansky-Giles, D. R., Johnson, C. D., Chou, R., Hurwitz, E. L., & Côté, P. (2018) · European Spine Journal · doi:10.1007/s00586-017-5434-7 · Cited by 33 · see citing works
Experiences of Hearing Loss and Audiological Rehabilitation for Older Adults With Comorbid Psychological Symptoms: A Qualitative Study
Laird, E., Bennett, R. J., Barr, C., & Bryant, C. (2020) · American Journal of Audiology · doi:10.1044/2020_aja-19-00123 · Cited by 32 · see citing works
Lack of Consensus Across Clinical Guidelines Regarding the Role of Psychosocial Factors Within Low Back Pain Care: A Systematic Review
Knoop, J., Rutten, G. M., Lever, C., Leemeijer, J., de Jong, L. J., Verhagen, A. P., van Lankveld, W., & Staal, J. B. (2021) · Journal of Pain · doi:10.1016/j.jpain.2021.04.013 · Cited by 33 · see citing works
The current state of pain education within Canadian physiotherapy programs: a national survey of pain educators
Wideman, T. H., Miller, J., Bostick, G. P., Thomas, A., Bussières, A., & Wickens, R. H. (2019) · Disability and Rehabilitation · doi:10.1080/09638288.2018.1519044 · Cited by 29 · see citing works
Psychosocial Influences on Low Back Pain: Why Should You Care?
Main, C. J., & George, S. Z. (2011) · Physical Therapy · doi:10.2522/ptj.2011.91.5.609 · Cited by 29 · see citing works
Self-citation
A comparative effectiveness trial of postoperative management for lumbar spine surgery: changing behavior through physical therapy (CBPT) study protocol
Archer, K. R., Coronado, R. A., Haug, C. M., Vanston, S. W., Devin, C. J., Fonnesbeck, C., Aaronson, O. S., Cheng, J. S., Skolasky, R. L., Riley, L. H., et al. (2014) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-15-325 · Cited by 29 · see citing works
Effects of behavioural exercise therapy on the effectiveness of multidisciplinary rehabilitation for chronic non-specific low back pain: a randomised controlled trial
Semrau, J., Hentschke, C., Peters, S., & Pfeifer, K. (2021) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-021-04353-y · Cited by 26 · see citing works
Recovery From Depressive Symptoms Over the Course of Physical Therapy: A Prospective Cohort Study of Individuals With Work-Related Orthopaedic Injuries and Symptoms of Depression
Wideman, T. H., Scott, W., Martel, M. O., & Sullivan, M. J. L. (2012) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2012.4182 · Cited by 26 · see citing works
Physical therapists’ assessments, analyses and use of behavior change techniques in initial consultations on musculoskeletal pain: direct observations in primary health care
Emilson, C., Åsenlöf, P., Pettersson, S., Bergman, S., Sandborgh, M., Martin, C., & Demmelmaier, I. (2016) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-016-1173-x · Cited by 27 · see citing works
Comparison of supervised exercise therapy with or without biopsychosocial approach for chronic nonspecific low back pain: a randomized controlled trial
Hrkać, A., Bilić, D., Obrdalj, E. Č., Baketarić, I., & Puljak, L. (2022) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-022-05908-3 · Cited by 30 · see citing works
Effect of exercise and manual therapy or kinesiotaping on sEMG and pain perception in chronic low back pain: a randomized trial
Blanco-Gímenez, P., Mampel, J. V., Gargallo, P., Maroto‐Izquierdo, S., Martín-Ruiz, J., Jaenada-Carrilero, E., & Barrios, C. (2024) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-024-07667-9 · Cited by 23 · see citing works
Pathoanatomy and classification of low back disorders
Ford, J. J., & Hahne, A. J. (2012) · Manual Therapy · doi:10.1016/j.math.2012.05.007 · Cited by 23 · see citing works
Physiotherapists’ Approaches to Patients’ Concerns in Back Pain Consultations Following a Psychologically Informed Training Program
Cowell, I., McGregor, A., O’Sullivan, P., O’Sullivan, K., Poyton, R., Schoeb, V., & Murtagh, G. (2021) · Qualitative Health Research · doi:10.1177/10497323211037651 · Cited by 22 · see citing works
Staying active after rehab: Physical activity perspectives with a spinal cord injury beyond functional gains
Baehr, L. A., Kaimal, G., Hiremath, S. V., Trost, Z., & Finley, M. A. (2022) · PLoS ONE · doi:10.1371/journal.pone.0265807 · Cited by 22 · see citing works
Advancing Pain Education in Canadian Physiotherapy Programmes: Results of a Consensus-Generating Workshop
Wideman, T. H., Miller, J., Bostick, G. P., Thomas, A., & Bussières, A. (2017) · Physiotherapy Canada · doi:10.3138/ptc.2016-57 · Cited by 21 · see citing works
Use of healthcare resources in patients with low back pain and comorbid depression or anxiety
Bailes, A. H., Navlani, R., Koscumb, S., Malecky, A., Marroquin, O. C., Wasan, A. D., Gutstein, H. B., Delitto, A., Zigler, C. K., Vo, N. N., et al. (2021) · The Spine Journal · doi:10.1016/j.spinee.2021.03.031 · Cited by 21 · see citing works
Comparative efficacy of three active treatment modules on psychosocial variables in patients with long-term mechanical low-back pain: a randomized-controlled trial
Mbada, C. E., Ayanniyi, O., & Ogunlade, S. O. (2015) · Archives of Physiotherapy · doi:10.1186/s40945-015-0010-0 · Cited by 19 · see citing works
Disability Trajectories in Patients With Complaints of Arm, Neck, and Shoulder (CANS) in Primary Care: Prospective Cohort Study
Miedema, H. S., Feleus, A., Bierma‐Zeinstra, S., Hoekstra, T., Burdorf, A., & Koes, B. W. (2015) · Physical Therapy · doi:10.2522/ptj.20150226 · Cited by 19 · see citing works
A physiotherapy-directed occupational health programme for Austrian school teachers: a cluster randomised pilot study
Figl-Hertlein, A., Horsak, B., Dean, E., Schöny, W., & Stamm, T. (2013) · Physiotherapy · doi:10.1016/j.physio.2013.03.003 · Cited by 18 · see citing works
Pain and Function in Home Care
Murtaugh, C. M., Beissner, K., Barrón, Y., Trachtenberg, M. A., Bach, E., Henderson, C., Sridharan, S., & Reid, M. C. (2016) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000410 · Cited by 18 · see citing works
A classification and treatment protocol for low back disorders
Ford, J. J., Richards, M. C., & Hahne, A. J. (2012) · Physical Therapy Reviews · doi:10.1179/1743288x12y.0000000034 · Cited by 18 · see citing works
The McKenzie method and its association with psychosocial outcomes in low back pain: a systematic review
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
Resolving the Burden of Low Back Pain in Military Service Members and Veterans (RESOLVE): Protocol for a Multisite Pragmatic Clinical Trial
Farrokhi, S., Esposito, E. R., McPherson, D., Mazzone, B. N., Condon, R., Patterson, C. G., Schneider, M., Greco, C. M., Delitto, A., Highsmith, M. J., et al. (2020) · Pain Medicine · doi:10.1093/pm/pnaa367 · Cited by 17 · see citing works
An examination of concepts in vocational rehabilitation that could not be linked to the ICF based on an analysis of secondary data
Finger, M. E., de Bie, R. A., Selb, M., & Escorpizo, R. S. (2016) · Work · doi:10.3233/wor-152251 · Cited by 16 · see citing works
Effects of behavioural exercise therapy on the effectiveness of a multidisciplinary rehabilitation for chronic non-specific low back pain: Study protocol for a randomised controlled trial
Semrau, J., Peters, S., Geidl, W., Hentschke, C., & Pfeifer, K. (2013) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-14-89 · Cited by 16 · see citing works
Becoming confidently competent: a qualitative investigation of training in cognitive functional therapy for persistent low back pain
Simpson, P., Holopainen, R., Schütze, R., O’Sullivan, P., Smith, A. J., & Kent, P. M. (2022) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2022.2151333 · Cited by 15 · see citing works
Kinesiology taping as an adjunct for pain management: A review of literature and evidence
Banerjee, G., Briggs, M., & Johnson, M. (2016) · Indian Journal of Pain · doi:10.4103/0970-5333.198005 · Cited by 15 · see citing works
Vulvovaginal Pain from a Fear-Avoidance Perspective: A Prospective Study Among Female University Students in Sweden
Ekdahl, J., Flink, I. K., Engman, L., & Linton, S. J. (2017) · International Journal of Sexual Health · doi:10.1080/19317611.2017.1404543 · Cited by 15 · see citing works
Study protocol for targeted interventions to prevent chronic low back pain in high-risk patients: A multi-site pragmatic cluster randomized controlled trial (TARGET Trial)
Delitto, A., Patterson, C. G., Stevans, J. M., Brennan, G. P., Wegener, S. T., Morrisette, D. C., Beneciuk, J. M., Freel, J. A., Minick, K. I., Hunter, S. J., et al. (2019) · Contemporary Clinical Trials · doi:10.1016/j.cct.2019.05.010 · Cited by 15 · see citing works
Self-citation
Educación al paciente con fibromialgia. Revisión sistemática de ensayos clínicos aleatorizados
Elizagaray-García, I., González, J. M., & Gil‐Martínez, A. (2016) · Revista de Neurología · doi:10.33588/rn.6202.2015446 · Cited by 26 · see citing works
The relationship between symptom severity, bother and psychological factors in women with pelvic organ prolapse: A cross‐sectional observational study
Drage, K., Aghera, M., MacKellar, P., Twentyman, R., Jacques, A., Chalmers, J., Neumann, P., Nurkic, I., & Thompson, J. A. (2021) · Neurourology and Urodynamics · doi:10.1002/nau.24842 · Cited by 13 · see citing works
Psychological Subgrouping to Assess the Risk for the Development or Maintenance of Chronic Musculoskeletal Pain
Linton, S. J., & Kienbacher, T. (2019) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000787 · Cited by 13 · see citing works
How manual therapy provided a gateway to a biopsychosocial management approach in an adult with chronic post-surgical low back pain: a case report
Toomey, D., Reid, D. A., & White, S. (2020) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2020.1813472 · Cited by 12 · see citing works
Remotely Delivered Psychologically Informed Mindful Movement Physical Therapy for Pain Care: A Framework for Operationalization
Sullivan, M. B., Hill, K., Ballengee, L. A., Knoblach, D., Fowler, C., Haun, J., & Saenger, M. (2023) · Global Advances in Integrative Medicine and Health · doi:10.1177/27536130231209751 · Cited by 10 · see citing works
Implementing high value back pain care in private physiotherapy in Australia: A qualitative evaluation of physiotherapists who participated in an “implementation to innovation” system
Gardner, C., Moseley, G. L., Karran, E. L., Wiles, L., & Hibbert, P. D. (2020) · Canadian Journal of Pain · doi:10.1080/24740527.2020.1732808 · Cited by 11 · see citing works
Sa12b Improves Biological Activity of Human Degenerative Nucleus Pulposus Mesenchymal Stem Cells in a Severe Acid Environment by Inhibiting Acid-Sensitive Ion Channels
Wang, Z., Han, L., Chen, H., Zhang, S., Zhang, S., Zhang, H., Li, Y., Tao, H., & Li, J. (2022) · Frontiers in Bioengineering and Biotechnology · doi:10.3389/fbioe.2022.816362 · Cited by 11 · see citing works
Helping workers help themselves: empowering physiotherapy clients to manage musculoskeletal problems at work
Johnston, V., & Shaw, W. S. (2013) · Physical Therapy Reviews · doi:10.1179/1743288x13y.0000000087 · Cited by 11 · see citing works
Biopsychosocial influence on shoulder pain: Rationale and protocol for a pre-clinical trial
George, S. Z., Staud, R. M., Borsa, P. A., Wu, S. S., Wallace, M. R., Greenfield, W. H., Mackie, L. N., & Fillingim, R. B. (2017) · Contemporary Clinical Trials · doi:10.1016/j.cct.2017.03.005 · Cited by 11 · see citing works
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Do prognostic variables predict a set of outcomes for patients with chronic low back pain: a long-term follow-up secondary analysis of a randomized control trial.
Garcia, A. N., Costa, L. O. P., Costa, L. D. C. M., Hancock, M. J., & Cook, C. E. (2019) · PubMed Central · doi:10.1080/10669817.2019.1597435 · Cited by 11 · see citing works
Experiences of training and delivery of Physical therapy informed by Acceptance and Commitment Therapy (PACT): a longitudinal qualitative study
Holmes, M. G., Wileman, V., McCracken, L. M., Critchley, D., March, M. K., Norton, S., Moss-Morris, R. E., Noonan, S., Barcellona, M. G., & Godfrey, E. L. (2020) · Physiotherapy · doi:10.1016/j.physio.2020.12.004 · Cited by 11 · see citing works
When sex hurts: Female genital pain with sexual consequences deserves attention: A position paper
Thomtén, J., & Linton, S. J. (2014) · Scandinavian Journal of Pain · doi:10.1016/j.sjpain.2014.04.001 · Cited by 9 · see citing works
The Prospective Prognostic Value of Biopsychosocial Indices of Sensitivity to Physical Activity Among People With Back Pain
Woznowski‐Vu, A., Aternali, A., Gervais, A., Pavilanis, A. D. S., Nijs, J., Sullivan, M. J. L., & Wideman, T. H. (2021) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000965 · Cited by 8 · see citing works
Efficient Screening for Fear of Movement in Outpatient Settings: Short Form and Computer Adaptive Tests for Fear Avoidance and Negative Pain Coping
Lentz, T. A., Kallen, M. A., Deutscher, D., & George, S. Z. (2021) · Physical Therapy · doi:10.1093/ptj/pzab256 · Cited by 9 · see citing works
Self-citation
Improving Physical Therapy Pain Care, Quality, and Cost Through Effectiveness-Implementation Research
Joyce, C. T., Schneider, M., Stevans, J. M., & Beneciuk, J. M. (2018) · Physical Therapy · doi:10.1093/ptj/pzy031 · Cited by 8 · see citing works
Protocol for a Parallel Group Randomized Clinical Trial Comparing a Culturally Adapted Cognitive Behavioral Telerehabilitation Intervention to Usual Physical Therapy for Latino Patients With Chronic Spine Pain
Gombatto, S. P., Archer, K. R., Wegener, S. T., Hernandez, Y., Lin, S., Godino, J., Dyke, J. V., Liu, J., & Monroe, K. S. (2023) · Physical Therapy · doi:10.1093/ptj/pzad068 · Cited by 8 · see citing works
Optimising management of low back pain through the pain and disability drivers management model: Findings from a pilot cluster nonrandomised controlled trial
Longtin, C., Décary, S., Cook, C. E., Tousignant, M., Lacasse, A., & Tousignant‐Laflamme, Y. (2023) · Musculoskeletal Care · doi:10.1002/msc.1738 · Cited by 8 · see citing works
The suitability and utility of the pain and movement reasoning model for physiotherapy: A qualitative study
Jones, L. E., Heng, H. W. F., Heywood, S. E., Kent, S., & Amir, L. H. (2021) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2021.1934922 · Cited by 7 · see citing works
Does early intervention improve outcomes in the physiotherapy management of lumbar radicular syndrome? Results of the POLAR pilot randomised controlled trial
Reddington, M., Walters, S. J., Cohen, J., Baxter, S. K., & Cole, A. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-021631 · Cited by 7 · see citing works
Low Back Pain Treatment by Athletic Trainers and Athletic Therapists: Biomedical or Biopsychosocial Orientation?
MacDougall, H. L., George, S. Z., & Dover, G. C. (2019) · Journal of Athletic Training · doi:10.4085/1062-6050-430-17 · Cited by 6 · see citing works
Self-citation
The association between depression and type of treatments received for chronic low back pain
Zubatsky, M., Witthaus, M., Scherrer, J. F., Salas, J., Gebauer, S., Burge, S. K., & Schneider, D. (2019) · Family Practice · doi:10.1093/fampra/cmz062 · Cited by 6 · see citing works
Physiotherapists’ perceptions on using a multidimensional clinical reasoning form during psychologically informed training for low back pain.
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A Convincing Case--For the Psychologically Informed Physical Therapist
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Authors: Nicholas, M. K., & George, S. Z.
Affiliations: The University of Sydney (AU)
University of Florida Health (US)
ORCID: Nicholas, Michael K.
George, Steven Z.
Venue: Physical Therapy
Publisher: Oxford University Press (OUP)
Published: 2011-05-01
Volume: 91
Issue: 5
Pages: 765-776
ISSN: 0031-9023 (ISSN-L)
1538-6724
DOI: 10.2522/ptj.20100278
OpenAlex: W2098866468
Cited by: 139
References: 93
Citations by year: 2026: 7 · 2025: 4 · 2024: 7 · 2023: 8 · 2022: 11 · 2021: 11 · 2020: 8 · 2019: 11 · 2018: 7 · 2017: 13 · 2016: 12 · 2015: 9 · 2014: 11 · 2013: 12 · 2012: 6
FWCI: 1.23
Type: journal article
Language: en
Open access: closed
Locations: Physical Therapy (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords: low back pain, psychological barriers, activity-based intervention, psychological principles, clinical reasoning, patient communication, treatment planning, physiotherapists, evidence-based recommendations
MeSH terms: Disability Evaluation, Humans, Pain Measurement, Patient Care Planning, Professional-Patient Relations, Psychophysiology, Risk Factors, Health Behavior, Low Back Pain, Practice Guidelines as Topic, Risk Assessment, Disease Management, Recovery of Function, Physical Therapy Modalities, Evidence-Based Practice

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Psychologically Informed Interventions for Low Back Pain: An Update for Physical Therapists

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