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Clinical Journal of Pain:
doi: 10.1097/AJP.0000000000000100
Special Topics Series: PDF Only

Subgrouping of Low Back Pain Patients for Targeting Treatments: Evidence from Genetic, Psychological and Activity-related Behavioral Approaches.

Huijnen, Ivan P.J. PhD; Rusu, Adina C. PhD; Scholich, Sarah MSc; Meloto, Carolina MSc; Diatchenko, Luda PhD, MD

Published Ahead-of-Print
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Many patients with low back pain (LBP) are treated in a similar fashion as if they were a homogenous group. However, scientific evidence is available that pain is a complex perceptual experience influenced by a wide range of genetic, psychological and activity-related factors. The leading question for clinical practice should be what works for whom. Main aim of the present review is to discuss the current state of evidence of subgrouping based on genetic, psychosocial and activity-related factors for understanding their contribution to individual differences. Based on these perspectives, it can be concluded that from different insights identifying patients based on specific characteristics is aimed for. For the genetics part, very promising results are available from other chronic musculoskeletal pain conditions. However, more research is warranted in LBP. With regard to subgroups based on psychosocial factors, the results underpin the importance of matching patients' characteristics to treatment. Combing this psychosocial profile with the activity-related behavioral style may be of added value in tailoring the patient's treatment to his/her specific needs. For future research and treatment it might be challenging to develop theoretical frameworks combining different subgrouping classifications. Based on this framework, tailoring treatments more specifically to the patient needs may result in improvements in treatment programs for patients with LBP.

(C) 2014 by Lippincott Williams & Wilkins

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