Pain Education in the Context of Non-Specific Low Back Pain: The Lived Experience of the Physiotherapist. An Interpretive Phenomenological Analysis

Objectives: The aim of this study was to explore the physiotherapists' lived experiences of providing pain education (PE), to people living with non-specific low back pain (NSLBP). In previous studies, PE has been associated with positive clinical outcomes within the physiotherapeutic management of NSLBP. However, the meaning of providing PE, as experienced by physiotherapists, has not been specifically explored. Methods: This study adopted a hermeneutic phenomenological approach to explore PE experiences. Six semi-structured interviews were conducted, interviews were transcribed and analysed in line with the ‘interpretative phenomenological analysis’ framework. Results: Five main thematic meaning structures emerged: Experienced significance of assessment in understanding NSLBP, PE as explaining the nature of NSLBP, Experienced challenges in providing PE, individualisation as key to PE for NSLBP and Reassurance as central to PE for people living with NSLBP. Conclusions: The significance of subjective assessment, was a key component of PE, as experienced by participants. However, differences were noted between participants in addressing the sense of assessment; in seeking a physiotherapeutic understanding of the NSLBP, and in seeking to understand the situation of those who are in pain. Within the participant experience, the significance of ‘patient’ reassurance was highlighted, related to the individualisation and outcome of PE. Reassurance, as described by participants, was emotive and practically grounded and linked with physical activity promotion. Individualisation in PE was meaningfully related to language modification and developing positive therapeutic relationships. Physiotherapists described PE particularly challenging related to pain chronicity and psychosocial factors, which may have significant implications to practice.