Pain and suffering: what is the unit?

Nonspecific low back pain presents several problems to health care providers. Although the number of patients who are registered as disabled due to low back pain has dramatically increased in recent years, its incidence and severity remain fairly constant. The relationship between perceived backache and subsequent disability is not linear, and other factors may influence a patient's decision to seek help. These factors include the patient's psychological and emotional state, especially his or her past experiences, extant mood and anxiety about anticipated consequences. Physicians should not rely on a simple 'disease model' when treating low back pain but should try to identify the biopsychosocial factors involved and should understand that pain and suffering are not always synonymous.