Goal achievement model for low back pain

摘要

In 1987, Spine, the official journal of the International Society for the Study of the Lumbar Spine (ISSLS) published 2 seminal articles regarding treatment outcomes for low back pain. First, editors Alf Nachemson and Henry LaRocca1 proclaimed that "old dictums must be challenged and new methods properly evaluated." They mandated randomized controlled trials using "scientifically validated forms for grading of low-back pain and disability," such as visual analogue scales and the Million, MMPI, Oswestry, and Waddell questionnaires. Second, Gordon Waddell applied George Engel's biopsychosocial model to low back pain.2>3 He observed that despite advances in the modern biomedical approach to diagnosing and curing painful pathology, disability from back pain had become a Western epidemic. He acknowledged that most people had back pain at some point, and most of them recovered quickly or just carried on without medical attention.