• Ian Cowell, Peter O'Sullivan, Kieran O'Sullivan, Ross Poyton, Alison McGregor, and Ged Murtagh.
• Department of Surgery and Cancer, Imperial College, London, UK. Electronic address: i.cowell13@imperial.ac.uk.
• Musculoskelet Sci Pract. 2018 Dec 1; 38: 113-119.

BackgroundPhysiotherapists have been urged to embrace a patient-oriented biopsychosocial (BPS) framework for the management of non-specific chronic low back pain (NSCLBP). However, recent evidence suggests that providing broader BPS interventions demonstrates small differences in pain or disability compared to usual care. Little is known about how to integrate a BPS model into physiotherapy practice and the challenges it presents.ObjectiveTo explore the perceptions of physiotherapists' in primary care in England adopting a BPS approach to managing NSCLBP patients.MethodQualitative semi-structured interviews were conducted with ten physiotherapists working in primary care. A purposive sampling method was employed to seek the broadest perspectives. Thematic analysis was used to analyse the interview transcripts and capture the emergent themes.ResultsThree main themes emerged: (1) physiotherapists recognised the multi-dimensional nature of NSCLBP and the need to manage the condition from a BPS perspective, (2) addressing psychological factors was viewed as challenging due to a lack of training and guidance, (3) engaging patients to self-manage their NSCLBP was seen as a key objective.ConclusionAlthough employing a BPS approach is recognised by physiotherapists in the management of NSCLBP, this study highlights the problems of implementing evidence based guidelines recommending that psychological factors be addressed but providing limited support for this. It also supports the need to allocate more time to explore these domains in distressed individuals. Engaging patients to self-manage was seen as a key objective, which was not a straightforward process, requiring careful negotiation.Copyright © 2018. Published by Elsevier Ltd.

21 keywords...

hide…