Social factors contributing to the development of chronic low back pain: a scoping review

Abstract

Background: Research and clinical practice approaches to 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, and to propose a classification system that offers a complementary perspective on social influences. Methods: Eight databases were searched following the JBI methodological guidelines for scoping reviews. The reporting of this review is guided by the PRISMA-ScR guidelines. 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. The protocol for this review was prospectively registered (DOI: https://doi.org/10.17605/OSF.IO/8DBJV). 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. The proposed classification provides a foundation for future research and may assist clinicians in better understanding the social dimensions of chronic pain, ultimately contributing to the development of more personalised interventions tailored to patients' social and life contexts.