Perception gaps between healthcare professionals and people with CLBP: an online survey of current primary care management practices in the United Kingdom

This study examined differences in perspectives and perceptual gaps in the management of chronic low back pain (CLBP) between healthcare professionals—general practitioners (GPs) and physiotherapists—and people with CLBP in United Kingdom primary care. A cross-sectional online survey was completed by 32 GPs, 53 physiotherapists, and 138 people with CLBP. Closed- and open-ended questions assessed management strategies, perceived effectiveness, treatment goals, and alignment of perspectives. Quantitative data were analysed descriptively and qualitative responses through content analysis. GPs most frequently recommended exercise (87.5%), analgesics (84.4%), and referral to physiotherapy (62.5%). Physiotherapists emphasised exercise (98%), pain education (73.6%), and active lifestyle advice (47.2%). Both groups prioritised active management, while patients most often reported analgesic use (44.9%) and passive treatments such as manual therapy (12.3%) and electrotherapy (12.3%). Regarding treatment goals, GPs and physiotherapists prioritised functional improvement, pain reduction, mental health, daily activity, and quality of life (all ≥80%), reflecting a biopsychosocial approach. Patients, however, focused mainly on pain relief (52.2%) and return to activity (33.3%), underscoring expectation gaps. While GPs and physiotherapists generally follow guideline-recommended, active strategies for CLBP, substantial differences remain between clinician recommendations and patient-reported practices and goals. Addressing these gaps requires enhanced communication, shared decision-making, and more person-centred care.