The importance of psychosocial aspects in clinical assessment

The biopsychosocial concept emphasises human illness rather than disease, Waddell and others have argued for a biopsychosocial approach to low back pain, encouraging patients to develop coping strategies in contrast to the traditional medical model which allows patients to take on a sick role. It has been suggested that patients should be assessed early on for psychosocial ‘yellow flags’ which increase the prognostic risk of chronicity. Assessment may be made using clinical assessments or questionnaires. The advantages and disadvantages of both are discussed as well as the practicality of using both in tandem. Both objective findings and subjective reporting should be investigated, in order to develop a complete overview of the patient's condition. It is important to identify patients who are at risk of not recovering from acute pain and to convert these patients to ‘pain copers’ rather than pain avoiders