How Do Physiotherapists Explain Influencing Factors to Chronic Low Back Pain? A Qualitative Study Using a Fictive Case of Chronic Non-Specific Low Back Pain

Rob Vanderstraeten, Antoine Fourré, Isaline Demeure, Christophe Demoulin, Jozef Michielsen, Sibyl Anthierens, Hilde Bastiaens and Nathalie Roussel ()
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Rob Vanderstraeten: Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
Antoine Fourré: Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
Isaline Demeure: Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
Christophe Demoulin: Department of Sport and Rehabilitation Sciences, University of Liege, EVAREVA, 4000 Liege, Belgium
Jozef Michielsen: Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
Sibyl Anthierens: Department of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
Hilde Bastiaens: Department of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
Nathalie Roussel: Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium

IJERPH, 2023, vol. 20, issue 10, 1-13

Abstract: Background: While pain is influenced by multiple factors including psychosocial factors, previous research has shown that physiotherapists still favour a biomedical approach. Purpose: To evaluate: (1) how physiotherapists explain the patient’s chronic non-specific low back pain (LBP); (2) whether physiotherapists use one or multiple influencing factors, and (3) whether these factors are framed in a biopsychosocial or biomedical approach. Materials and methods: This exploratory qualitative study uses a vignette depicting chronic non-specific LBP and employs a flexible framework analysis. Physiotherapists were asked to mention contributing factors to the pain based on this vignette. Five themes were predefined (“Beliefs”, “Previous experiences”, “Emotions”, “Patients behaviour”, “Contextual factors”) and explored. Results: Physiotherapists use very brief explanations when reporting contributing factors to chronic pain (median 13 words). Out of 670 physiotherapists, only 40% mentioned more than two different themes and 2/3rds did not see any link between the patients’ misbeliefs and pain. Only a quarter of the participants mentioned the patient’s worries about pain and movement, which is considered to be an important influencing factor. Conclusion: The lack of a multifactorial approach and the persistent biomedical beliefs suggest that it remains a challenge for physiotherapists to fully integrate the biopsychosocial framework into their management of chronic LBP.

Keywords: biopsychosocial; belief; chronic; behaviour; physiotherapy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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