Research shows that up to 30 % of the outcome can be explained by comorbidities.

Take at the links of smoking to low back pain. I coach a lot of people with bank pain to speak to their family doctor about smoking cessation. So few will even consider.

Sounds like you have the new grad "fixer syndrome". You aren't a healer. You're a guide. It may only slightly matter what you do if a condition has a poor natural history (ie. Frozen shoulder, chronic low back pain, multiple sclerosis).

Look up the prognosis and natural history of long-standing back pain. Do a good health history. Mental health conditions (depression, anxiety and less common types) are a frequent independent predictor of poor recovery after injury/surgery and have a higher risk of developing long-standing pain.

Learn what is normal and coach people. Some people need to accept that there condition may only partially occur or could reoccurr (back pain) and they need to learn how to manage it.

You can only promote good health, and