'Sometimes I feel like the only physio in the whole wide world, so alone'.
Brett J Mason, Romy Parker, Martha Geiger
PMID 40612925WHAT IT FOUND
Physiotherapists in South African primary care describe feeling isolated and overwhelmed by high-impact chronic pain cases.
They report lacking time, support, and training. They value person-centred care and peer support but struggle to deliver them within resource-constrained public systems.
Key findings
01Participants described feeling isolated and overwhelmed, with some noting that high-impact chronic pain cases constitute the majority of their clinical workload.
02Key barriers to effective care include insufficient time due to large caseloads, a lack of interdisciplinary support, and gaps in physiotherapists' own knowledge and training regarding pain science.
03Facilitators identified by participants include collaborative, person-centred approaches, patient education, and group therapy or peer support, though implementing these requires resources often unavailable in primary care.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study included only eight participants, all physiotherapists from the Western Cape, which limits the transferability of findings to other provinces or disciplines. The researcher was an insider (a physiotherapist working in the same sector), which may have influenced data collection and analysis despite reflexive strategies. The sample was small and non-representative of all physiotherapists in South Africa, with no participants from the West Coast district. As a qualitative study, it reports perceptions and experiences rather than measuring clinical outcomes or the effectiveness of specific interventions.
Declared interests
The research was funded by the Harry Crossley Foundation, Stellenbosch University, and the South African Society of Physiotherapy (SASP) Pain Management Physiotherapy Group.
The easy way to misread this
Do not interpret the participants' reported needs for more staff and training as evidence that current physiotherapy interventions for chronic pain are ineffective. The study describes the clinicians' experience of barriers to delivering care, not the clinical outcomes of the care itself.