Physiotherapists Using the Biopsychosocial Model for Chronic Pain: Barriers and Facilitators - A scoping review

Authors Han van Dijk, Albère Köke, Stefan Elbers, Jurgen Mollema, Rob Smeets, Harriët Wittink
Published in International Journal of Environmental Research and Public Health
Publication date 2023
Research groups Lifestyle and Health
Type Article


The use of the biopsychosocial model in primary care physiotherapy for chronic pain is far from the recommendations given in research and current guidelines. To understand why physiotherapists have difficulty implementing a biopsychosocial approach, more insight is needed on the barriers and facilitators. This scoping review aimed to investigate and map these barriers and facilitators that physiotherapists working in primary care reportedly face when treating patients with chronic musculoskeletal pain from a biopsychosocial perspective. Four electronic databases (PubMed, Embase, CINAHL and ERIC) and the grey literature were searched. Studies were included if they investigated the experiences of physiotherapists in the treatment of chronic pain from a biopsychosocial perspective in primary care. Extracted data were discussed and sub grouped in themes following a qualitative content analysis approach. To align with current use of theories on behavior change, the resulting themes were compared to the Theoretical Domains Framework. After screening, twenty-four studies were included. Eight groups of barriers and facilitators were identified, thematically clustered in six themes: knowledge, skills, and attitudes; environmental context and resources; role clarity; confidence; therapeutic alliance; and patient expectations. The results of this review can be used to inform the development of implementation programs.

On this publication contributed

Language English
Published in International Journal of Environmental Research and Public Health
Year and volume 20 2
Key words chronic pain, biopsychosocial, physiotherapy, primary health care, barriers and facilitators

Han van Dijk

Han van Dijk MPT

Han van Dijk

  • PhD candidate
  • Research group: Lifestyle and Health