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Environmental Physiotherapy for Chronic Spinal Pain Management: An International Modified Delphi Study
Emmanuelle Opsommer1, Natalya Korogod1, Aníbal Manuel Melo Pereira1
1HESAV School of Health Sciences-Vaud, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.
European Journal of Pain (London, England)
|August 11, 2026
Summary
This study established expert consensus on sustainable physiotherapy for chronic spinal pain. Recommendations were developed to integrate environmental sustainability into pain management, promoting planetary health.
Area of Science:
- Physiotherapy
- Environmental Sustainability
- Public Health
Background:
- Chronic spinal pain presents a significant public health challenge.
- Current management strategies rarely address the environmental impact of healthcare.
- Environmental sustainability is crucial for responsible chronic pain care.
Purpose of the Study:
- To achieve consensus on integrating environmental sustainability into chronic spinal pain management.
- To develop recommendations for sustainable physiotherapy practices.
- To align pain management with planetary health goals.
Main Methods:
- A modified three-round Delphi study involving international physiotherapists.
- Review of clinical guidelines and sustainable practice literature.
- Consensus defined by an interquartile range (IQR) ≤ 1.
Main Results:
- 49 statements achieved consensus as recommendations for sustainable physiotherapy.
- Experts from diverse backgrounds and regions participated.
- The study identified key domains for integrating sustainability.
Conclusions:
- Broad international consensus was reached on sustainable physiotherapy for chronic spinal pain.
- The findings provide a framework for future guidelines, research, and education.
- This work supports more sustainable and responsible pain management practices.
