Patient Perspectives on Physical Therapy for Chronic Low Back Pain amongst Minority Populations in a Safety-net Hospital

Saturday, October 25, 2025

8:00 AM - 9:15 AM MT

Location: Original Research Theater

Has Audio

Primary Author(s)

Adrian Vallejo, MD

Resident
UCSF Health
San Francisco, California

Co-Author(s)

Patricia Zheng, MD

Associate Professor
University of California San Francisco
San Carlos, California
CO

Conor ONeill, MD

Clinical Professor
Department of Orthopedics, University of California San Francisco
San Francisco, California
ED

Emilia De Marchis, MD, MAS

Senior Physician Specialist
San Francisco Department of Public Health
San Francisco, California
MN

Masato Nagao, MD, PhD

Professor
University of California San Francisco
San Francisco, California
TB

Tigist Belaye, Ms

Research Manager
UCSF Orthopaedic Trauma Institute
San Francisco, California
AH

Aamna Haq, Other

Clinical Research Coordinator
University of California, San Francisco
San Francisco, California
DG

David Gendelberg, MD

Assistant Professor
University of California, San Francisco
San Francisco, California
JL

Jeffrey Lotz, PhD

Professor, Department of Orthopaedic Surgery
University of California San Francisco
San Francisco, California
KD

Karina Del Rosario, MD

Associate Clinical Professor
University of California San Francisco
San Francisco, California

Disclosure(s):

Adrian Vallejo, MD: No financial relationships to disclose

Patricia Zheng, MD: No financial relationships to disclose

Masato Nagao, MD, PhD: No financial relationships to disclose

Background and/or Objectives: Black, Hispanic and Asian American or Pacific Islander (AAPI) patients disproportionally report worse chronic low back pain (cLBP) severity and disability. Physical therapy (PT) is the most common non-pharmacological intervention recommended for cLBP. While minority populations face socioeconomic barriers to PT, little is known regarding their experiences and perceptions of PT. This study explored perceptions and preferences towards PT in minority populations to guide interventions to reduce health disparities.

Design: Qualitative research using thematic analysis of focus groups.

Setting : Urban safety-net academic-affiliated county hospital in United States.

Participants : Patients were recruited from an urban academic-affiliated county hospital if they 1) met the NIH Research Task Force recommended definition of cLBP, 2) self-identified as at least one of the following racial/ethnic groups: Black, Hispanic, or Asian American or AAPI, and 3) preferred to speak English, Spanish or Cantonese.

Interventions: Focus groups were conducted in participants’ preferred language. Semi-structured focus group guides probed on participants’ experiences with cLBP care, including PT. Interviews were transcribed and analyzed using qualitative thematic analysis.

Main Outcome Measures: Emergent themes from qualitative analysis.

Results: Eight focus groups with 30 participants included 15 English-preferring (mean age 59 years, 60% female, 60% Black, 40% Hispanic, and 13% AAPI) and 15 non-English-preferring patients (mean age 61 years, 60% female, 53% Hispanic and Spanish-preferring, and 47% AAPI and Cantonese-preferring).
Four themes were identified: 1) desire for group-based exercises and support, 2) negative perceptions of PT due to limited access and appointment lengths, 3) desire for hands-on therapy and manipulation, and 4) empowerment through education.

Conclusions: Patients with cLBP from minoritized populations reported frustrations with limited access to PT but acknowledged the value in PT interventions that focus on education and group-based support. Our findings may inform a more patient-centered approach for the treatment of cLBP in minority populations.