Abstract
BackgroundChronic low back pain (CLBP) prevalence has steadily increased over the last two decades. Manual therapy (MT) is recommended within a multimodal management approach to improve pain and disability although evidence investigating the patients’ experience of MT is scarce.ObjectiveTo explore expectations and perceptions of MT techniques in people with CLBP.MethodsA qualitative study embedded sequential to an experimental trial using semi-structured interviews (SSI) explored participants’ experiences of thrust, non-thrust and sham technique. Purposive sampling enabled variance in age and CLBP duration. An evidence informed topic guide was used. Data were analysed using thematic analysis (TA). Respondent validation and peer debriefing enhanced trustworthiness. The Consolidating Criteria for Reporting Qualitative Studies (COREQ) reported methodological rigour.FindingsTen participants (50% male) with a mean age of 29.1 years (Standard Deviation (SD): 7.9, range: 19–43), a mean pain intensity of 4.5 on a Numeric Rating Scale (NRS) 0–10 (SD: 1.5, range: 2–7), a mean Oswestry Disability Score (ODI) of 9 (SD: 4.6, range: 2–17) and a mean Tampa Scale of Kinesiophobia (TSK) score of 38.6 (SD: 4.8, range: 30–45) participated. Four themes were identified: understanding of pain; forming expectations; perception of care; re-evaluation of body awareness and management. Understanding of CLBP is formed by an individuals’ pain perception and exchange with social environment. This, combined with communication with physiotherapist influenced expectations regarding the MT technique.ConclusionExpectations for MT were formed by an individual’s social environment and previous experience. A treatment technique is perceived as positive if its characteristics are aligned with the individual’s understanding of pain and if care is delivered in an informative and reassuring manner.
Highlights
The point prevalence of chronic low back pain (CLBP) is estimated as 19.6% between 20 and 59 years of age [1]
Manual therapy (MT) in combination with education and exercise is recommended for management of Chronic low back pain (CLBP) [14]
Following four main themes were identified in the data (Fig. 2): Understanding of pain, the perception of care, forming expectation and the re-evaluation of body awareness and management
Summary
The point prevalence of chronic low back pain (CLBP) is estimated as 19.6% between 20 and 59 years of age [1]. Research investigating factors for developing CLBP continues to be of interest [2, 3]. Alongside significant impairment in daily tasks and social interaction [7, 8], recent research reports a change in sensory and emotional perception in people with CLBP [9, 10]. Influencing factors for patient satisfaction in management of CLBP include reduction in pain, regaining perception and function [12, 13]. Chronic low back pain (CLBP) prevalence has steadily increased over the last two decades. Manual therapy (MT) is recommended within a multimodal management approach to improve pain and disability evidence investigating the patients’ experience of MT is scarce
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