Physiotherapists may stigmatise or feel unprepared to treat people with low back pain and psychosocial factors that influence recovery

This study attempted to answer the question of what physiotherapists’ perceptions about identifying and managing the cognitive, psychological and social factors that may act as barriers to recovery for people with low back pain (LBP) are. Three main themes emerged: physiotherapists only partially recognised cognitive, psychological and social factors in LBP, with most discussion around factors such as family, work and unhelpful patient expectations; some physiotherapists stigmatised patients with LBP as demanding, attention-seeking and poorly motivated when they presented with behaviours suggestive of these factors; and physiotherapists questioned the relevance of screening for these factors because they were seen as extending beyond their scope of practice, with many feeling under-skilled in addressing them.

Physiotherapists partially recognised cognitive, psychological and social factors in people with LBP. Physiotherapists expressed a preference for dealing with the more mechanical aspects of LBP, and some stigmatised the behaviours suggestive of cognitive, psychological and social contributions to LBP. Physiotherapists perceived that neither their initial training, nor currently available professional development training, gave them the required skills and confidence to successfully address and treat the multidimensional pain presentations seen in LBP.