Clinicians' views on treating adolescent nonspecific back pain

The number of adolescents with nonspecific persistent back pain appears to be on the rise. Evidence for the rehabilitation of adolescent back-pain patients is limited, and guidance for treating adolescent nonspecific persistent back pain as a biopsychosocial phenomenon may not be widespread.
 
Therefore, my supervisors and I agreed that a deeper understanding of the practices, perspectives, and beliefs of healthcare practitioners treating this group of adolescents would be an appropriate way to gather on-the-ground experiences of clinicians and inform future intervention research.
 
To do this, I developed an interview guide and undertook individual, semi-structured interviews with 10 clinicians (eight chartered physiotherapists, one nurse, and one psychologist) who currently treat or have treated adolescents with nonspecific persistent back pain.
 
Because this was an exploratory, descriptive study, reflexive thematic analysis was used to code the interview transcripts and generate relevant themes.
 
The five themes that captured the practices, perspectives, and beliefs of interviewed clinicians were:

1. Multiple relationships, one priority
2. Without buy-in, it won’t work
3. Managing pain, living life
4. No one-size-fits-all treatment
5. Who you see is what you get.

 
Details of each theme are explained, with relevant supporting data, in the full publication linked below. But our conclusions based on the data were as follows:

• Treating an adolescent with nonspecific persistent back pain is not the same as treating an adult patient with the same condition.
• The lack of legal autonomy of adolescents with nonspecific persistent back pain contributes to the complexity of their treatment, as clinicians must attend to the needs, concerns, and beliefs of both adolescents and their parents.
  
• Clinicians aim to offer person-centered care to adolescents with nonspecific persistent back pain. However, they currently lack guidance on how to foster effective treatment relationships with parents and how to achieve buy-in to a modern conceptualization of persistent back pain as a biopsychosocial phenomenon.
  

 
If you treat young people with persistent pain, you might find yourself and your own experience reflected in this paper. Casual conversations with clinicians after the first publication of this research confirmed that the experiences of these 10 clinicians accurately reflect the experiences of many.
 
Click the image below to link to the full open-access article.
 
Hauber SD, Robinson K, O’Sullivan K. ‘It can be very complicated’: A qualitative analysis of clinicians’ practices and perspectives on treating adolescents with nonspecific persistent back pain. Clin Rehabil. 2025;39(4):549-558. doi:10.1177/02692155251324589

Click image to read open-access article.