Social factors as outcome predictors in the assessment of chronic low back pain according to a biopsychosocial approach: a scoping review

Background and Objective: The Biopsychosocial (BPS) approach offers a comprehensive view of the onset and progression of chronic low back pain (CLBP), but it often prioritizes the biological aspects over the psychosocial and behavioral components. However, conceptualising CLBP as the result of interactions between individuals and their environment can provide crucial insights into its evolution and inform effective care strategies. This scoping review aims to identify situational and sociological factors contributing to CLBP and their predictive potential for the persistence of CLBP.Databases and Data treatment: We interrogated 8 databases following recommendations from the JBI and PRISMA. All forms of evidence were eligible, including grey literature, but sources were excluded if they referred only to acute pain or if they included only biological factors. Based on the PCC framework: Population: adults with CLBP; Concept: The evolution of CLBP according to the BPS model; Context: Use of situational factors in predicting CLBP evolution in research and clinical practice. Two authors independently selected articles for inclusion, extracted data and performed the analysis.Results: 35 articles meeting the inclusion criteria were selected. We identified 28 categories of sociological and situational factors potentially related to the development of CLBP. These were classified into 6 domains that covered a range of different perspectives - from individual to macro.Conclusions: We have categorized sociological factors, like working conditions, social support, and economic status, which appear to be related to the development and maintenance of CLBP via their action on mental health, coping strategies, and pain perception.