Physical activity for chronic back pain: qualitative interviews among patients and GPs

Abstract

Background: Chronic back pain (CBP) is common among patients in primary care and is associated with significant personal and socioeconomic burden. Research has shown that physical activity (PA) is one of the most effective therapies to reduce pain. However, for general practitioners (GP) it remains challenging to advise and encourage individuals with CBP to exercise regularly. Aim: To provide insight into views and experience on PA in individuals with CBP and GPs. To reveal facilitators and barriers for engaging in PA. Design and Setting: Qualitative semi-structured interviews with 14 individuals with CBP and 12 GPs in Germany between June and December 2021. Method: Interviews were coded separately by consensus and analysed thematically. Findings of the two groups were compared and summarised. Results: Opinion and experience on PA in individuals with CBP were similar both within and across the GP and patient groups. Interviewees expressed their views on internal and external barriers affecting PA. They provided strategies to address these barriers and concrete recommendations to increase PA. However, our study revealed a conflictual doctor-patient-relationship that ranged from paternalistic to partnership-based to service provision. This might lead to negative perceptions on both sides such as frustration and stigma. Conclusion: To the best of our knowledge, this is the first qualitative study exploring opinion and experience of PA in individuals with CBD and GPs in parallel. Our study reveals a complex doctor-patient-relationship and provides an important insight into motivation for and adherence to PA in individuals with CBP.