The Portuguese osteopaths' attitudes towards a biomechanical or biopsychosocial model in the approach of chronic low back pain – A cross-sectional questionnaire-based survey

Objective

This study investigated the Portuguese Osteopaths attitudes towards a biomechanical or biopsychosocial approach of care in patients with chronic low back pain (cLBP).

Methods

A cross-sectional questionnaire-based survey of Portuguese registered osteopaths was composed using sociodemographic determinants, the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and Pain Attitudes and Beliefs for Physiotherapists (PABS-PT). The HC-PAIRS assesses the attitudes and beliefs about the functional expectations of patients with cLBP, and the PABS-PT assesses the dominant model of care.

Results

Portuguese registered osteopaths (n = 103) had mean PABS-PT subscale scores of 29.6 ± 7.7 [CI95% 28.12–31.14] (biomechanical) and 22.9 ± 5.3 [CI95% 21.88–23.94] (biopsychosocial). The mean HC-PAIRS total score was 52.4 ± 9.0 [CI95% 50.66–54.16]. There was a strong and positive correlation between the HC-PAIRS and the PABS-PT biomechanical subscale (n (103) = 0.55, p < 0.001, and in PABS-PT a negative correlation between the biomechanical and biopsychosocial subscale scores (n(103) = -0.21, p = 0.028).

Conclusions

Portuguese osteopaths tend to adopt a biomechanical model of care instead of a biopsychosocial model in the management of patients with chronic low back pain. They seem to agree that chronic low back pain was due entirely to tissue damage, indicating strong biomechanical beliefs about the pain that may ultimately influence their clinical decisions.