Multidisciplinary Biopsychosocial Rehabilitation for Nonspecific Chronic Low Back Pain

<LEAP> highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions—medications, surgery, education, nutrition, exercises—and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature.¹ Each article in this PTJ series will summarize a Cochrane review or other scientific evidence resource on a single topic and will present clinical scenarios based on real patients to illustrate how the results of the review can be used to directly inform clinical decisions. This article focuses on the effectiveness of multidisciplinary biopsychosocial rehabilitation for nonspecific chronic low back pain. Can multidisciplinary biopsychosocial rehabilitation help this patient with chronic low back pain?

Low back pain (LBP) is an important public health problem worldwide.² The economic burden associated with this condition is enormous in most countries, and it is the leading cause of years lived with disability.³ Although patients with acute LBP typically have a favorable prognosis, approximately 40% will develop chronic LBP, defined as pain lasting for 12 weeks or longer.⁴ Chronic LBP is responsible for the majority of costs of LBP.⁵

Increasingly, chronic LBP is conceptualized within a biopsychosocial model, and accordingly interventions that target the biological, psychological, and social contributors to the condition have become popular.⁶ One treatment approach based on the biopsychosocial model is multidisciplinary biopsychosocial rehabilitation, where patients receive treatment from a range of health professionals with different skills to reduce …