Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.