Patients’ expectations and experiences of accelerated access to physiotherapy for sciatica: qualitative findings from a mixed-methods study

Abstract

ObjectivesPhysiotherapy is often utilised in the management of sciatica and yet little research has been undertaken to examine patient expectations and experiences of physiotherapy and its timing. This study reports patient expectations and experiences of accelerated access to physiotherapy for sciatica. Setting & ParticipantsParticipants with clinically diagnosed sciatica (n=33) were recruited for individual interviews (n=46) from 14 National Health Service (NHS) primary care general practices, and one physiotherapy service provider in the same city in England. DesignThis was a nested qualitative study within a pilot randomised controlled trial evaluating accelerated access to physiotherapy for sciatica. Interviews with consenting participants were undertaken with some participants prior to randomisation and again after completion of physiotherapy (n=13), some before treatment commencement (n=7) and others only after cessation of treatment (n=13). All interviews were audio recorded and thematically analysed. ResultsThree themes emerged from the interviews: participants’ expectations of physiotherapy, with negative expectations of physiotherapy being associated with experiences of previous unhelpful physiotherapy. Secondly, the perceived therapeutic value of accelerated physiotherapy in managing sciatica and preventing physical and psychological deterioration. Finally, the value of a personalised approach, with a physiotherapist who actively listened in partnership, and who provided a bespoke multimodal regimen. ConclusionFindings from this study suggest that accelerated access to physiotherapy has value in terms of aiding perceived recovery and/or halting further physical and psychological decline. An individualised patient approach alongside accelerated access to physiotherapy should be considered for patients with sciatica.