Development of physical therapy for non-specific low back pain based on a biopsychosocial model

Abstract

Low back pain is a significant problem in the world and in Japan. It is understood that about 70% of non-specific low back pain improves in 4-6 weeks, but the remaining 30% becomes chronic. It is widely known that psychosocial factors, in addition to structural and functional problems, are responsible for the chronicity and delayed improvement of non-specific low back pain. Therefore, it is necessary to consider non-specific low back pain based on a biopsychosocial model. In addition, the concepts of classification and stratified care have been developed to identify the direction of specific interventions by grouping low back pain according to its characteristics, rather than considering it as a single condition. Physical therapy management for non-specific low back pain based on the biopsychosocial model requires different strategies depending on the duration of the disease, and more multifaceted strategies are needed in the chronic phase. In recent years, a new intervention called Cognitive Functional Therapy, which is a multifaceted intervention method consisting of the three components of "Making Sense of Pain," "Exposure with Control," and "Lifestyle Change," has been proposed. Since 80% of low back pain is non-specific that does not require surgery, the evolution of physical therapy will help to decrease the number of low back pain patients.