Education of patients with chronic lower back pain in physiotherapy practice: experience of physiotherapists and patients

To investigate the experience of physiotherapists in educating patients during therapy and the experience of patients with chronic low back pain receiving an educational intervention as part of physiotherapy treatment.

The study was conducted as a qualitative study design. Eight patients receiving inpatient rehabilitation for chronic low back pain at National Rehabilitation Centre "Vaivari" and five certified physiotherapists who work with low back pain patients on a daily basis participated in the study. Participants were interviewed using a semi-structured interview model. The interviews were transcribed as text, with each participant assigned a recognition code. Interview transcripts were analysed using inductive contingency analysis.

The results of the study revealed six common themes in the patient sample: patient education during sessions, information received during education, perception of information, patient involvement in rehabilitation, knowledge about future rehabilitation and education as part of rehabilitation. The seven themes for the sample of physiotherapists were: types of patient education, amount of information, information provided by physiotherapists to patients, patient education during sessions, timing of education, role of education during rehabilitation and continuing education.

Physiotherapists educate people with chronic low back pain through talking, demonstrating exercises and handouts, but filming patients for therapy purposes has become an increasingly popular method to keep educational information in a patient-friendly way. Physiotherapists don’t explain the diagnosis, but this information is important for patients to understand the pain. Physiotherapists and patients with chronic low back pain define friendly relationships, positive emotions, clarification of goals, adaptation to the patient's daily routine, empathy of the physiotherapist and the ability to motivate and guide the treatment as facilitating factors for the provision of education during treatment and the perception of the information provided, but as inhibiting factors are: patients' expectations and not listening to the therapist, the physiotherapist not wanting to know the patient's daily habits and the quality of the handouts. 

Patients with chronic low back pain consider education as an important part of rehabilitation. It would be valuable to highlight this topic in the field of rehabilitation, to promote successful rehabilitation outcomes.