g. family, friends, other), the size of the network (e.g. number of people who offer support), the type of support offered (emotional, instrumental, information, appraisal) and the rating of satisfaction for the support (perceived support) so that future synthesis is possible. The search strategy used in this review was comprehensive, with a wide-ranging search of electronic databases, supplemented by hand-searches of cited literature, reference lists and local databases. However, the review only included studies written in English

within peer reviewed journals, and so may have missed important findings from other sources (grey literature). The method of quality assessment has advantages in terms of using a best evidence synthesis. The synthesis gives find more structure to the assessment of the included articles and also addresses some of the issues of heterogeneity outlined by Hoogendoorn et al.’s previous review. One disadvantage of this, within this review, is that only a few articles could be compared for each category (e.g. type of support) leading to conclusions of inconsistency.

There is also the issue of quality assessment, in that study quality was assessed as a whole for each study, but many lower quality studies employed better measures of social support. In terms of clinical relevance, the overall picture suggests that informal social support may be an important factor in the psychological well-being of the person with spinal pain, but the evidence is generally inconclusive. Furthermore, STK38 although speculative, the evidence does suggest there may be greater relevance of informal social Z-VAD-FMK concentration support effects for older persons with spinal pain and that there may be greater effects for those with neck pain, but further research is needed. This review has shown that there is inconclusive evidence of an effect of informal social support on the risk of occurrence of spinal pain. Evidence

on prognosis is inconsistent and more research is required before conclusions can be made. Cross-sectional findings show a weak effect for instrumental support and pain and moderate evidence of an effect of satisfaction with the level of informal social support and psychological outcomes. More research is needed fully understand the influence of informal social support on nonspecific spinal pain using measures that encompass the complex dimensions of informal social support. Systematic review advice from Jo Jordan and Danielle van der Windt both from the Arthritis Research UK Primary Care Centre, Keele University. Funding from the Wellcome Trust [083572]. “
“Back pain is common in the general population; around 30% have low back pain (LBP) during any 1 month (Papageorgiou et al., 1995 and Webb et al., 2003), and at least 60% of adults experience LBP during their lifetime (Papageorgiou et al., 1995, Hillman et al., 1996 and Walsh et al., 1992).