Article

Originally the term "yellow flags" was used to describe psychosocial prognostic
factors for the development of disability following the onset of musculoskeletal
pain. The identification of yellow flags through early screening was expected to
prompt the application of intervention guidelines to achieve secondary
prevention. In recent conceptualizations of yellow flags, it has been suggested
that their range of applicability should be confined primarily to psychological
risk factors to differentiate them from other risk factors, such as social and
environmental variables. This article addresses 2 specific questions that arise
from this development: (1) Can yellow flags influence outcomes in people with
acute or subacute low back pain? and (2) Can yellow flags be targeted in
interventions to produce better outcomes? Consistent evidence has been found to
support the role of various psychological factors in prognosis, although
questions remain about which factors are the most important, both individually
and in combination, and how they affect outcomes. Published early interventions
have reported mixed results, but, overall, the evidence suggests that targeting
yellow flags, particularly when they are at high levels, does seem to lead to
more consistently positive results than either ignoring them or providing omnibus
interventions to people regardless of psychological risk factors. Psychological
risk factors for poor prognosis can be identified clinically and addressed within
interventions, but questions remain in relation to issues such as timing,
necessary skills, content of treatments, and context. In addition, there is still
a need to elucidate mechanisms of change and better integrate this understanding
into the broader context of secondary prevention of chronic pain and disability.

Langue : ANGLAIS