- Contrary to the previous belief, serious injury does not necessarily cause severe pain; there is a great individual variation.
- A new "biopsychosocial pain syndrome" model should replace the "injury model.
- Another study reports physical loading at work or in sports has a barely perceptible impact on disc degeneration and that routine or repetitive loading my actually have a beneficial effect on the disc, delaying the disc desiccation associated with aging.
- Summarizing the above-mentioned studies suggests the concept of backache at the primary care level should be shifted, from "spinal injury" to "biopsychosocial pain syndrome", from "morphological abnormality" to "mechanical functional disorder"m and "self-limiting and good prognosis2 to "repeated recurrences."
- The new "biopsychosocial pain syndrome model2 is not without problem. Firstly, there is no screening instrument. There is no simple way to assess psychosocial problems. Secondly, there is no simple treatment for patients with deeply involved psychosocial problems. Doctors should recognize the importance of "care" as well as "cure." Lastly, the approach based on this new concept depends on each doctor's good will and not on financial reward.
- It has been pointed out that the doctor's attitude is a key factor for improvement in treatment outcome and patient satisfaction.
- It was, therefore, concluded that the surgical outcome for degenerative lumbar spine disease was influenced by preoperative psychiatric problems.
