Psychosocial Risk Factors

1
Psychosocial Risk Factors
Psychosocial Risk Factors

• YELLOW FLAGS
• These are beliefs and behaviours relating to
  back pain which may indicate the possibility of
  long term problems

2
Psychosocial Risk Factors

• A belief that back pain is harmful or potentially
  severely disabling
• simple mechanical back pain varies with
  physical activity
• pain is a symptom not a condition

3
Guidance for back pain management

• An understanding of the causes of back pain and
  the expected outcome
• An understanding of the benefits of activity over
  rest
• Prescribed painkillers to enable activity

4
Psychosocial Risk Factors

• Fear-avoidance behaviour ( avoiding a movement or
  activity due to misplaced anticipation of pain)
  and reduced activity levels.
• Avoidance behaviour maintains and exacerbates
  fear

5
Guidance for back pain management

• Encourage people with back pain to continue
  normal activity as much as possible emphasising
  flexibility
• Once a worker is off work for 4-12 weeks there is
  a 10-40 risk of still being off after one year.
  After 1-2 years absence it is unlikely they will
  return to any form of work in the foreseeable
  future

6
Psychosocial Risk Factors

• Tendency to low mood and withdrawal from social
  interaction
• If people are inactive then they will become
  excluded from their usual activities and feel
  isolated

7
Guidance for back pain management

• Reinforce the value of maintaining activity
• They need to know that recovery is quicker with
  activity than rest
• Enable them to remain at work even for small
  parts of the day

8
Psychosocial Risk Factors

• 4. Expectation of passive treatments rather than
  a belief that active participation will help
• Rest is not a treatment for back pain
• Back care lasts 24 hours a day
• Physical therapy including manipulation can
  assist in symptom relief

9
Guidance for back pain management

• Understanding the structure and function of the
  spine and its need for movement
• Understanding the limitations of passive
  treatment