Behavioral factors in the management of back pain.

Most persons with acute back problems recover promptly. Comprehensive evaluation of those who have not significantly improved within two weeks will often reveal significant behavioral factors that may be impeding recovery. These factors may include interpersonal, economic or occupational stress; psychologic disorders, including anxiety, depression or somatization, and counterproductive beliefs about back disorders. Effective management strategies include building a constructive doctor-patient relationship, addressing life stress issues, keeping patients physically active and prescribing psychotropic and/or analgesic medication when appropriate.