Management of chronic low back pain patients by osteopaths: a qualitative study

Background. Chronic low back pain represents a complex therapeutic situation for factual medicine, requiring the consideration of psychosocial factors. The recent and abundant offer of care by osteopathy can lead general practitioners to discuss the interest for patients suffering from chronic low back pain of consulting an osteopath. ctives. To describe the specificity of the clinical and decisional approach of these chronic low back pain patients and to explore how osteopaths who are neither doctors nor physiotherapists take into account their psychosocial risk factors. Methods. This was a qualitative study using semi-structured interviews with "neither-nor" osteopaths established in loire-atlantique. A thematic analysis of the interviews was carried out. Results. Eleven interviews were conducted with "neither-nor" osteopaths, who described an approach different from medical reasoning, paying little specific attention to the low back pain complaint, which they managed like any other pain complaint. While psychosocial factors such as mental suffering were integrated in their approach, osteopaths' management difficulties had not previously been extensively explored. Conclusion. Conceptual and linguistic differences can render it difficult for physicians to dialogue with patients undergoing osteopathic treatment. It is therefore in the patients' interest that physicians acquire better knowledge of this discipline in order to understand its functioning and to try to identify situations in which it would be interesting.