Managing Complexity: Physiotherapists’ experience of managing persons with persistent low back pain

Physiotherapists’ experience of managing persons with persistent low back pain.

Elisavet Anastasiadi and Clair Hebron (2021).

Low back pain is one of the leading causes of disability globally. Most back pain episodes resolve quickly but a significant number of people report having back pain that lasts more than 3 months. The current understanding is that persistent low back pain (PLBP) is a complex presentation requiring a multidimensional approach. This is reflected in the evolution from a biomedical to a psychosocial model of care in physiotherapy. This approach has proven to be a challenge for physiotherapists.
Objectives: To explore the physiotherapists’ experience of managing persons with persistent low back pain.
Methods: The study employed a qualitative approach drawing on Interpretative Phenomenology. The aim was to seek understanding through the exploration of the physiotherapists’ personal experience of managing persons with persistent low back pain (PLBP). Four physiotherapists were interviewed through semi-structured interviews to acquire an example of their experience of managing persons with PLBP. The data was analysed using Thematic Analysis.
Results: Four master themes were generated as a result of the analysis of the clinicians’ descriptions: Managing complexity in persons with PLBP, negotiation with the person, person – physiotherapist relationship and management strategies.
Conclusion: The clinicians described the complexity of managing persons with PLBP. They described management strategies that align with the NICE 2016 guidelines. They conveyed the belief that the person should be in control and described their role as being supportive in the therapeutic process. Finally they described behaviours they felt helped in forming a therapeutic alliance. These findings offer further insights into the physiotherapists’ experience of managing persons with PLBP.
Contribution of the paper
•In depth insight of the complexity of managing persons with persistent low back pain.
•The physiotherapists’ accounts implied a belief that the person should be in control of the therapeuticprocess.
•Identification of behaviours that participants perceived would facilitate development of the therapeuticalliance

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