Linton systematically reviewed 913 articles on psychological factors in neck and back pain, constructing a table of 37 prospective studies to answer whether psychological variables contribute to pain onset, acute/subacute pain, and the transition to chronicity — and which specific variables matter most.
When a spine patient presents acutely, screen for fear-avoidance beliefs, catastrophizing, and depressive symptoms from the first visit — these variables predict chronicity more reliably than most biomedical findings and are the targets of the New Zealand 'yellow flags' framework this paper helped justify.
Psychological risk stratification is not a chronic-pain-only tool; the evidence shows it is most actionable early, before disability is established.
Linton systematically reviewed 913 articles on psychological factors in neck and back pain, constructing a table of 37 prospective studies to answer whether psychological variables contribute to pain onset, acute/subacute pain, and the transition to chronicity — and which specific variables matter most.
When a spine patient presents acutely, screen for fear-avoidance beliefs, catastrophizing, and depressive symptoms from the first visit — these variables predict chronicity more reliably than most biomedical findings and are the targets of the New Zealand 'yellow flags' framework this paper helped justify.
Psychological risk stratification is not a chronic-pain-only tool; the evidence shows it is most actionable early, before disability is established.