BMJ  2005;331:88 (9 July), doi:10.1136/bmj.38498.495000.E0 (published 20 June 2005)

Commentary

Early psychosocial interventions for low back pain in primary care

¹ University of Manchester, Calderbank Research Unit, Manchester M20 3JQ
cjmain@gmail.com

The first 150 words of the full text of this article appear below.

The paper by Jellema and colleagues is the first to attempt systematically to incorporate psychosocial management in the treatment of back pain by general practitioners in a primary care setting.¹ The success of pain management programmes in "reversing" the impact of chronic incapacity in a proportion of patients with apparently intractable chronic pain has led to an interest in secondary prevention,^{2 3} as the sort of factors that seemed to respond to cognitive behaviour therapy had also been shown to be early risk factors for chronicity.⁴ A specific focus by general practitioners on psychosocial obstacles to recovery has recently been recommended,⁵ but no controlled evaluation of this type of intervention has previously been carried out. Jellema and colleagues, in their well designed and controlled study, seem to have shown that such an approach, compared with "usual treatment," is no more effective. This seems puzzling at first sight and certainly merits some . . . [Full text of this article]

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