Chinese physiotherapists’ perspectives on managing low back pain: a qualitative study

This study investigated Chinese physiotherapists’ role in the healthcare system, their explanatory models for low back pain (LBP) causes and treatment strategies, and their perspectives on biopsychosocial models for LBP in Chinese rehabilitation. Between February 2021 and June 2022, qualitative semi-structured online interviews were conducted with 19 physiotherapists (N = 19) from East China, who had experience treating LBP patients. Interviews were analysed through inductive thematic analysis. Three themes and five sub-themes were found in our study about Chinese physiotherapists’ insights for LBP care. These themes include constrained autonomy of Chinese physiotherapists within Chinese LBP care, the somatic-based LBP management model in physiotherapy, and a blended understanding of pain within the Chinese context. Our findings highlight that LBP rehabilitation in China is shaped by: (1) systemic constraints, including a strict medical hierarchy relied on doctors’ prescription and limited physiotherapy autonomy; (2) a somatic-based explanatory model continues to dominate Chinese physiotherapists’ clinical reasoning and treatment choices; and (3) a blended pain philosophy, combining dominant somatic-based LBP beliefs with acknowledgements of psychosocial and TCM perspectives of pain.