‘I just don’t have the tools’ – Italian osteopaths’ attitudes and beliefs about the management of patients with chronic pain: A qualitative study

Full Paper

Authors: Formica A, Thomson O.P., Esteves J. E.
Journal: IJOM, March 2018Volume 27, Pages 6–13



Chronic pain is a complex and challenging problem for manual therapists, such as osteopaths, especially in identifying and managing the multiplicity of psychosocial factors associated with chronic musculoskeletal pain. This study explored Italian osteopaths’ attitudes and beliefs towards chronic pain, particularly their understanding of the biomedical and biopsychosocial (BPS) dimensions of chronic pain, and the role they play in their clinical practice.


A qualitative study was conducted using in-depth semi-structured interviews. A purposive sample of 11 osteopaths practising in Italy was recruited from a poster advert sent to 8 Italian osteopathic schools. Interview data were transcribed verbatim and interpreted using a constructivist approach to grounded theory as a framework for data collection, analysis, and conceptualisation.


Three themes were constructed from the data: 1) process of patient evaluation; 2) professional view; 3) developing professional knowledge.


Osteopaths displayed a greater orientation towards the biomedical dimensions of chronic pain than dimensions associated with the BPS model. Although the importance of the BPS model has been recognised as part of the osteopathic philosophy of clinical practice and the role of psychosocial factors (PS) are considered important in pain experience, the osteopaths included in this study highlighted a lack of knowledge and skills to assess and address psychosocial risk factors in the management of long term pain sufferers. These findings indicate the need for osteopaths to acquire additional skills and knowledge in professional training programs to develop a more operational holistic view in managing chronic pain sufferers.

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