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Eur Spine J. 2018 Sep;27(Suppl 6):828-837. doi: 10.1007/s00586-017-5434-7. Epub 2018 Jan 27.

The Global Spine Care Initiative: a narrative review of psychological and social issues in back pain in low- and middle-income communities.

Author information

1
Division of General Medical Rehabilitation, Geneva University and University Hospital, Geneva, Switzerland. christine.cedraschi@hcuge.ch.
2
Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland. christine.cedraschi@hcuge.ch.
3
Department of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.
4
World Spine Care Europe, Holmfirth, UK.
5
Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
6
Department of Neurology, University of California, Irvine, Irvine, CA, USA.
7
World Spine Care, Santa Ana, CA, USA.
8
Faculty of Health Sciences, Institute of Technology, University of Ontario, Oshawa, Canada.
9
UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada.
10
Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, Canada.
11
Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
12
National University of Health Sciences, Lombard, IL, USA.
13
Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA.
14
Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
15
Office of Public Health Studies, University of Hawaii, Honolulu, HI, USA.

Abstract

PURPOSE:

The purpose of this review was to describe psychological and social factors associated with low back pain that could be applied in spine care programs in medically underserved areas and low- and middle-income countries.

METHODS:

We performed a narrative review of cohort, cross-sectional, qualitative and mixed methods studies investigating adults with low back pain using Medline and PubMed were searched from January 2000 to June 2015. Eligible studies had at least one of the following outcomes: psychological, social, psychosocial, or cultural/ethnicity factors. Studies met the following criteria: (1) English language, (2) published in peer-reviewed journal, (3) adults with spinal disorders, (4) included treatment, symptom management or prevention.

RESULTS:

Out of 58 studies, 29 were included in this review. There are few studies that have evaluated psychological and social factors associated with back pain in low- and middle-income communities, therefore, adapting recommendations from other regions may be needed until further studies can be achieved.

CONCLUSION:

Psychological and social factors are important components to addressing low back pain and health care providers play an important role in empowering patients to take control of their spinal health outcomes. Patients should be included in negotiating their spinal treatment and establishing treatment goals through careful listening, reassurance, and information providing by the health care provider. Instruments need to be developed for people with low literacy in medically underserved areas and low- and middle-income countries, especially where psychological and social factors may be difficult to detect and are poorly addressed. These slides can be retrieved under Electronic Supplementary Material.

KEYWORDS:

Communication barriers; Physician–patient relations; Psychology; Psychosomatic medicine; Somatosensory disorders; Spine

PMID:
29374779
DOI:
10.1007/s00586-017-5434-7

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