Self-management support for people with non-specific low back pain: a qualitative survey among Italian
Matteo Cioeta1, Gabriele Giannotta2, Domenico Carbotti1
1Department of Medicine and Health Science Vincenzo Tiberio, University of Molise, Campobasso, Italy.
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.
