Background and aims: Evidence-based recommendations for practitioners treating back pain emphasize adequate screening of work-related factors, and good communication with employers. It has been argued that getting all the stakeholders onside – including practitioners – could reduce sickness absence. However, expanding the role of clinicians to include exploration of occupational obstacles to recovery, and targeting these within the framework of clinical intervention is controversial. Private musculoskeletal practitioners (MPs) including physiotherapists, chiropractors and osteopaths treat a considerable section of those seeking care for low back pain (LBP). This study aimed to explore how private musculoskeletal practitioners view their role.

Method: A semi-structured interview was carried out with 15 physiotherapists, 16 chiropractors and 14 osteopaths. The interview schedule included questions about the relationship between work & health; communication with employers and GPs; strategies in returning/maintaining patients at work; and sick leave certification. Interviews were audio-taped & transcribed, and content analysis was carried out to extract themes. These were reviewed on a sample of interviews by another researcher, and independently reviewed against verbatim quotes by a third researcher.

Results: There was a consensus that work was in general good for psychological well being, but work-specific issues were also seen as threats to back pain. Most practitioners viewed patients who would not take time off work or moderate work-practices as the strongest threat for further problems. There was very limited communication with employers or GPs, but most practitioners gave advice about moderating work-duties.

In conclusion, private musculoskeletal practitioners explore work-related issues, and see return to work as an important treatment goal.

Conflict of Interest: None

Source of Funding: British Academy and BackCare