A critical review of the biopsychosocial model of low back pain care: time for a new approach?

Review written by Dr Sandy Hilton info

Key Points

  1. Physiotherapy literature on low back pain does not adequately address social aspects of care.
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BACKGROUND & OBJECTIVE

Low back pain (LBP) continues to be a leading cause of disability worldwide. Clinical guidelines around the world recommend the adoption of a biopsychosocial (BPS) model of care for the assessment and treatment of LBP (1). The authors of this review acknowledge the history of the BPS model as an effort to consider the contributors to pain and disability, and question if the conceptual model is being applied in practice.

The aim of this study was to explore the concepts and assumptions underpinning the use of the BPS model in the literature. The authors also explored if in the use of the BPS model some conceptualizations are given more weight than others. Have we truly moved out of the biomedical model of care to an inclusive model that addresses the complexity of LBP?

Clinical guidelines recommend the adoption of a biopsychosocial model of care for the assessment and treatment of LBP.
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We are too often missing important components of the human experience of LBP due to a bias of biomedical focus.

METHODS

This was a literature review with 66 included studies, which was then assessed using a qualitative critical review of “Foucauldian discourse analysis” to look at how the BPS model was used in the included articles (2). In this model, discourse

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