Highlights Psychosocial symptoms are important predictors of those that do worse with chronic low back pain. Currently the prevailing view is that psychosocial symptoms drive systemic inflammation. Psychosocial problems increase inflammation, and inflammation increases psychosocial symptoms. Psychosocial treatments decrease inflammation and reducing inflammation improves psychosocial symptoms. The relationship is bidirectional and we should remember this when dealing with patients with psychosocial symptoms. Explaining this relationship to patients may reduce the stigma associated with psychosocial...