'It can be very complicated': A qualitative analysis of clinicians' practices and perspectives on treating adolescents with nonspecific persistent back pain

Objective To explore the practices, perspectives and beliefs of clinicians treating adolescents with nonspecific persistent back pain.Design A qualitative descriptive study using individual, semi-structured interviews. Reflexive thematic analysis was used to code interview transcripts and generate relevant themes.Setting Clinicians in any clinical setting where adolescents with nonspecific persistent back pain are treated.Participants Ten clinicians (eight chartered physiotherapists, one nurse and one psychologist) who currently treat or have treated adolescents with nonspecific persistent back pain.Results Five themes were identified which captured the practices, perspectives and beliefs of clinicians treating adolescents with nonspecific persistent back pain: (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, and (5) Who you see is what you get.Conclusions Treating an adolescent with nonspecific persistent back pain is not the same as treating an adult with the same condition. Specifically, clinicians must attend to the needs, concerns and beliefs of both adolescents and their parents, reflecting the diminished autonomy of adolescent patients. Clinicians tend to offer person-centred 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 conceptualisation of persistent back pain as a biopsychosocial phenomenon.