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Table 5 Statements from primary health care providers about therapeutic exercise as a treatment for chronic low back pain

From: Misbeliefs about non-specific low back pain and attitudes towards treatment by primary care providers in Spain: a qualitative study

Subthemes

Quotations

Therapeutic exercise improves pain while unsupervised physical exercise aggravates the pain

“I think it has positive repercussions if you do directed physical activity. I think it is very positive. For me the most. Then there are the negative repercussions of doing the opposite” (BM 1).

“Exercise without effort, that is to say, don’t go to the gym to do weights or rowing or anything else that can make you more tired” (BM 3)

“If we move, if we walk, if we try positional education of sitting, of standing, of lifting, of all this, I think it helps. Because you will not get hurt. We will not hurt our nerves or our backs” (RN 4).

“Poor movement can worsen, but exercise improves pain” (BM 5).

Mechanisms underlying the benefits of therapeutic exercise on pain

“For the unblocking of the muscles or the strengthening of the blood supply. When one moves an area because it provides more irrigation, that area is more nourished” (RN 5).

“The more rehabilitation, the more movement, because the head is also doing well. So, if you are very sedentary and very inactive, it makes your head think only of pain, sorrow, sickness, and you have more and more. If your head is very inactive and you exercise a lot, the pain is reduced” (RN 2).

“We are happier (if we exercise). More well-being and more happiness” (RN 4).

Difficulties in prescribing therapeutic exercise

“There are patients who do not walk, you tell them to stretch or go to the physical therapist, they don’t do it [...] They prefer to take medication” (RN 4).

“Do a controlled, healthy, very conscious activity [...] always supervise. For example, by a physical therapist. I think that is more appropriate than a nurse or even a doctor” (RN 5)

“In some centres in Spain, they already have a physical therapist. Here it was asked for, it is asked for. It is one of the demands that is made” (BM 3).