One element of social support not commonly recognised in the LBP literature is the empathy and
understanding of clinicians who may provide social support through patient education and advice. In
the majority of LBP cases with no identifiable aetiology or complication, clinicians play a critical role in
allaying patient fears, making lifestyle recommendations, promoting activity resumption and
providing realistic expectations for recovery [49,50]. While the psychological impacts of chronic LBP
are well documented, patients with acute episodes or exacerbations of LBP can similarly report
elevated levels of psychological distress [51]. Thus, the reassurance and support provided by clinicians
is a factor in LBP recovery. More patient-centred interviewing strategies and more proactive efforts of
clinicians to address lifestyle and workplace concerns have been associated with improved LBP outcomes
and greater patient satisfaction [52–55], though the research in this area is generally sparse.
Even highly distressed patients appear unlikely to volunteer their frustration and lifestyle concerns in
an initial consult for LBP [56]; hence, more deliberate efforts may be needed to evaluate psychological
distress along with a physical examination. More research is needed to determine the extent to which
this provider-based variety of social support can be effectively leveraged to support improved LBP
outcomes in general consultations.