Perception of Physiotherapists towards the management of Chronic Low Back Pain (CLBP) from Biopsychosocial (BPS) Perspectives

Abstract

Background: Chronic low back pain (CLBP) is a leading cause of disability worldwide and presents a significant burden on individuals and healthcare systems. Traditional biomedical approaches often fail to address the complex interplay of physical, psychological, and social factors that contribute to CLBP. The biopsychosocial (BPS) model offers a more holistic framework for assessment and management. However, the extent to which physiotherapists understand and implement this model in clinical practice remains unclear. This study aimed to explore the perceptions of physiotherapists towards the management of CLBP through a biopsychosocial perspective. Methods: The study used a qualitative phenomenological methodology. Purposive sampling was used to select 13 participants who are working at Musculoskeletal unit of CRP-Savar & Mirpur. In-depth, semi-structured interviews were conducted using a self-developed question. The average length of the interview was 20-30 minutes. Interviews were conducted in Bengali the first language of the participants and the researcher. The interviews were audio-recorded and transcribed verbatim then analyzed thematically to identify recurring patterns and insights regarding participants’ experiences, beliefs, and challenges in applying the BPS model. NVivo 12 software was used to analyze the data. Results: The results revealed that physiotherapists generally recognized the importance of psychological and social influences in CLBP but the application of BPS model varies. Seven main themes emerged: (1) Varied understanding of the BPS model, (2) Biomedical focus prevails, (3) limited psychological integration, (4) Social context overlooked, (5) Patient beliefs as barrier, (6) Systemic barriers, (7) Need for professional development. Despite their awareness, many participants are facing difficulties in integrating the BPS approach into consistent clinical practice. Conclusion: This study highlights a gap between theoretical knowledge and practical application of the BPS model among physiotherapists. Addressing these gaps through targeted education, systemic support, and interdisciplinary teamwork may enhance the integration of the BPS model in CLBP management and improve patient outcomes. Keywords: chronic low back pain, biopsychosocial model, physiotherapy