Social factors at home
Support at home can be another factor in LBP recovery and functional improvement. This is likely a
reciprocal relationship, as LBP can also disrupt family roles and responsibilities, cause stress to family relationships and compromise levels of support. While there is evidence of a detrimental consequence
of LBP on marital satisfaction, partner emotions and relationship quality [34], there are also beneficial
effects of spousal support on LBP coping and function [34,35]. Most of the research on family support
and LBP has focussed on‘ spousal ’communication and emotional support, with a focus on operantconditioning
models whereby pain behaviour elicits a communicative interpretation and reaction
from partners, and this either reinforces or extinguishes pain behaviours [34,36–38]. If pain behaviour
appears to be reinforced by overly sympathetic (solicitous) responses from the patients’ partner or
family, perhaps this issue could be addressed in the lifestyle advice provided by clinicians.