Musculoskeletal practitioners’ perceptions of contextual factors that may influence chronic low back pain outcomes: a modified Delphi study - Chiropractic & Manual Therapies

Lastly, the panel’s collective views indicated that the patient-practitioner relationship was perceived as the most important CF during cLBP treatment. The UK panel displayed a high degree of consensus regarding practitioner’s beliefs and characteristics as CFs capable of influencing clinical outcomes. It is possible that MSK practitioners are unaware of the role of social or observational learning mechanisms associated with placebo analgesia [1, 3, 15]. Another example may include targeted interventions to address MSK practitioners misinformed or erroneous beliefs (e.g., use of imaging scans for LBP management/diagnosis) [63]. Both the UK panel and the Italian physiotherapists [18] perceived the treatment environment as the least important CF overall.