Background

Chronic low back pain (CLBP) is a multidimensional condition shaped by the interplay of biopsycho-social factors. Despite known clinical and demographic predictors of outcome, less is understood about the role of pain conceptualization in routine outpatient physiotherapy (OPT), where most patients receive conservative care.

Objectives

This study aimed to examine: (i) short-term effects of OPT on pain, disability, and quality of life; (ii) associations between demographic-clinical characteristics and post-treatment outcomes; (iii) relationships be-tween baseline factors and change scores; and (iv) whether pain conceptualization independently predicts treatment outcome.

Material and methods

A secondary, pre-post analysis was conducted in adults with CLBP (n = 84) who received a standardized 10-day OPT. Pain (NPRS), disability (RMDQ), quality of life (EQ-5D-5L, EQ-VAS), and pain conceptualization (COPI-Adult) were assessed. Descriptives, paired t-Tests, Pearson correlations, and linear regression were performed (α = 0.05).

Results

Significant and clinically meaningful improvements were observed across all outcomes: pain (ΔNPRS = -2.42), disability (ΔRMDQ = -5.27), EQ-5D index (Δ = 0.129), and EQ-VAS (Δ = +13.8). Age, gender, BMI, and pain duration showed no consistent associations with outcomes or improvement. In contrast, higher COPI-Adult scores were significantly associated with lower post-treatment pain and disability and better HRQoL. Regression analysis confirmed that pain conceptualization was an independent predictor of functional improvement (β = -0.222; p = 0.039), explaining additional variance beyond age.

Conclusions

After short, effective treatment, pain conceptualization emerged as the only consistent predictor of treatment outcome, highlighting the importance of cognitive-educational factors and supporting the integration of biopsychosocial approaches into OPT.