Self-management support for people with non-specific low back pain: a qualitative survey among Italian physiotherapists.

BACKGROUND

Non-specific low back pain (NSLBP) is the leading cause of global disability, and self-management is considered a key component of care. However, physiotherapists' approaches to supporting self-management can be improved.

OBJECTIVE

To explore how Italian physiotherapists conceptualize and enact self-management support for non-specific low back pain, and to describe perceived barriers and enablers to its implementation in routine practice.

METHODS

An online SurveyMonkey questionnaire was administered in February 2024 to assess Italian physiotherapists' knowledge and experience with self-management strategies for NSLBP. The survey consisted of 15 open-ended questions adapted from a Dutch study. Responses were analysed using inductive thematic analysis.

RESULTS

Thirty physiotherapists (21 female, mean age 30.4 ± 8.7 years) participated. Four themes emerged: (1) Therapeutic interaction style: active, passive, or multimodal?; (2) The patient as the main actor; (3) Self-management as more than a single tool; and (4) The physiotherapist's role in the self-management journey. Most participants viewed self-management support as essential and commonly used education as their primary strategy, while recognising its limitations. Although a variety of treatment approaches was reported, many remained grounded in biomechanical reasoning. A majority expressed the need for further knowledge and skills to better support self-management.

CONCLUSION

Most participants recognised the importance of self-management in treating NSLBP but did not fully align with its core principles. Although they emphasised patient-focused, person-centred care, it remains unclear whether these principles are truly applied. Over half indicated a need for additional skills, consistent with broader challenges physiotherapists face in integrating self-management strategies.