Social factors contributing to the development of chronic low back pain: a scoping review
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Background: Research and clinical practice aimed at understanding chronic low back pain (CLBP) have predominantly focused on biomedical and psychological aspects, often overlooking social influences. The biopsychosocial (BPS) model provides a theoretical framework for conceptualizing CLBP as the outcome of complex interactions between individuals and their environment, offering valuable insights into its progression and informing effective care strategies. This scoping review seeks to identify social factors contributing to CLBP, with particular attention to those examined for their predictive role in its persistence.Methods: Eight databases were searched following JBI and PRISMA guidelines, including all forms of evidence. Sources were selected based on the Population-Concept-Context (PCC) framework, specifically targeting studies involving adults with CLBP assessed through the BPS model. The focus was on social factors linked to CLBP evolution in the context of Westernized countries. Two researchers independently screened articles for inclusion, extracted data, and conducted the analysis.Results: Among the 35 articles meeting inclusion criteria, we identified 28 categories of social factors potentially associated with CLBP. These factors were organized into six domains spanning from individual-level influences to broader societal contexts.Conclusions: This review provides a comprehensive overview of social factors influencing CLBP. Within each domain, we identified factors assessed for their predictive role in CLBP development. Our proposed classification offers a foundation for future research and may support clinicians in better understanding the social dimensions of chronic pain, ultimately contributing to more person-centered and effective care approaches.