title: Returning back pain patients to work: how private musculoskeletal practitioners outside the national health service perceive their role (an interview study).
abstract: BACKGROUND
  Private musculoskeletal practitioners treat a large section of people with back pain, and could play an important role in returning and maintaining patients to work.
  
  
  METHODS
  We conducted a qualitative study to explore the self-perceived role of such practitioners in the UK. We interviewed 44 practitioners, including chiropractors, osteopaths and physiotherapists.
  
  
  RESULTS
  Thematic analysis of the interview transcripts indicated that return to work is a high priority for patients, many of whom are self-employed. Although in general work was perceived as beneficial to health, practitioners perceived work as a threat for some of their back pain patients. They perceived their role as giving ergonomic, postural and exercise based advice, but were more reluctant to address psychosocial problems related to back pain. A common view was that patients' reluctance to take a break from work impacted badly on their condition, and many practitioners advocated a short time off work duties to focus on rehabilitation. Contact with employers was very limited, and determined by the patients' request.
  
  
  CONCLUSIONS
  In summary, the study identifies several areas in which further education could expand the role of musculoskeletal practitioners and benefit their back pain patients. However, further study is required to determine whether these results are generalisable beyond the limits of this qualitative study UK based study.
authors.affiliation: Department of Psychology, Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK. t.pincus@rhul.ac.uk
authors.forename: Tamar
authors.initials: T
authors.lastname: Pincus
authors.forename: Alison
authors.initials: A
authors.lastname: Woodcock
authors.forename: Steven
authors.initials: S
authors.lastname: Vogel
mesh_terms: D000062:Accidents, Occupational / Q000523:psychology; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001416:Back Pain / Q000523:psychology / Q000534:rehabilitation*; D002684:Chiropractic; D004651:Employment / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009140:Musculoskeletal Diseases / Q000534:rehabilitation* / Q000628:therapy; D055360:Osteopathic Physicians; D026761:Physical Therapy Specialty; D010818:Practice Patterns, Physicians'; D017149:Private Sector; D024382:Professional Role; D036301:Qualitative Research; D018582:Sick Leave; D006113:United Kingdom