Exploring the perceived management priorities between physiotherapy and osteopathy for chronic low back pain

Purpose:
Physiotherapists and osteopaths are integral to the management of chronic low back pain (CLBP), yet patient confusion often arises due to overlap in their roles and techniques. Whilst existing literature has examined the approaches of each profession separately, limited research explores the perceived roles and management priorities. Thus, the aim of this study was to explore the perceived roles and management priorities of physiotherapists and osteopaths in addressing CLBP.
Methods:
A qualitative phenomenological design was used. Individual online semi-structured interviews were conducted with five UK-based healthcare professionals; two physiotherapists and three osteopaths. Participants were recruited through volunteer sampling and data was collected from December 2024 to February 2025. Thematic analysis, guided by an inductive approach, was used to analyse the findings.
Results:
Four themes emerged; ‘What we strive to achieve’; ‘Laying the foundation for Recovery’; Prioritising the patient’s needs’; and ‘Barriers to effective management’. Both physiotherapists and osteopaths acknowledged their roles in easing pain and improving mobility but different in their management priorities. Physiotherapists focused on exercise prescription, whilst osteopaths prioritised hands-on techniques. However, both professionals prioritise patient needs, yet, patient expectations, time limitations and skill gaps were identified to impede management.
Conclusion(s):
This study emphases that, although both professionals have similarities, differences exist. The findings are vital in helping clinicians gain a deeper understanding of each profession’s unique role, which could encourage interdisciplinary collaboration. Moreover, these insights enable clinicians to educate patients to increase their understanding to support informed decision-making and reduce confusion.
Impact:
For clinicians, effectively communicating the similarities and differences between physiotherapists and osteopaths is crucial for enhancing patient understanding and this can empower patients to make informed decisions aligned with their recovery goals, ultimately improving satisfaction and reducing confusion. Furthermore, the study provides an opportunity for each profession to gain a deeper understanding of the other’s role. Given that physiotherapists and osteopaths in this study note no collaboration with the other profession, enhancing this understanding could lead to more effective referrals, if needed, and the potential for interdisciplinary collaboration, ensuring that patients with CLBP receive the most appropriate care.