Moore James E
Rehabilitation Institute of Washington, 4300 Aurora Avenue North, Suite 100, Seattle, WA 98103, USA.
Phys Med Rehabil Clin N Am. 2010 Nov;21(4):801-15. doi: 10.1016/j.pmr.2010.06.005.
Psychosocial factors are at least as important as biomedical factors in the onset, maintenance, and treatment of chronic low back pain. This article reviews some of the common psychosocial factors that influence the course of pain from acute to chronic status, cognitive behavioral interventions used to alter dysfunctional pain cognitions, and avoidance behaviors and the emotional distress that can accompany pain and pose barriers to recovery. The interplay of cognitive, emotional, behavioral, biomedical, and social factors is described using a fear avoidance model. Interdisciplinary pain rehabilitation is discussed as an effective option for more biopsychosocially complex patients.
心理社会因素在慢性下腰痛的发病、维持和治疗中至少与生物医学因素同样重要。本文回顾了一些常见的心理社会因素，这些因素影响着疼痛从急性状态转变为慢性状态的过程，还回顾了用于改变功能失调性疼痛认知的认知行为干预措施、回避行为以及可能伴随疼痛并对康复造成障碍的情绪困扰。使用恐惧回避模型描述了认知、情绪、行为、生物医学和社会因素之间的相互作用。对于生物心理社会状况更为复杂的患者，跨学科疼痛康复被视为一种有效的选择进行了讨论。
