The experiences of physiotherapists regarding self-management practices for patients with non-specific chronic low back pain, South Africa: A qualitative study

Abstract

Background: Chronic non-specific low back pain (CNLBP) is one of the most common musculoskeletal conditions reported worldwide. Self-management interventions have been reported to be effective and affordable in managing CNLBP. However, few studies have been conducted in low- and middle-income countries, and their use by physiotherapists remains a global challenge.
Objectives: This study aimed to gather physiotherapists’ input regarding self-management of CNLBP in the Limpopo province of South Africa.
Method: A descriptive, exploratory qualitative study design was used. Physiotherapists working with CNLBP management were selected, and online interviews were conducted in English. Thematic analysis was used to analyse the data using ATLAS.ti software.
Results: Twenty-one physiotherapists participated in interviews. Participants’ experiences were diverse. Six themes emerged: (1) Physiotherapists’ understanding of patients’ beliefs and practices, (2) Presentation of patients with CNLBP, (3) Elements of treatment, (4) Impact of social factors, (5) Accessibility to primary healthcare services, and (6) Interprofessional teamwork. These findings emphasise elements that must form part of a self-management programme.
Conclusion: The biopsychosocial model of self-management, which includes a variety of exercises, educational programmes, socioeconomic factors, and interprofessional care, is esteemed as the most effective form of treatment and significantly improves access to primary healthcare.
Clinical Implications: Healthcare professionals are advised to implement a biopsychosocial approach throughout the treatment process to enhance patient-centred care, taking into account patients’ beliefs and practices regarding CNLBP, its presentation, key elements of treatment, the role of social factors, access to services, and interprofessional teamwork.