Saskia Baltrusch

30 Chapter 2 “What I see regarding low-back pain is that people underestimate themselves in what they are able to do, like: I can’t lift this, and then you do a test and actually they are able to lift it.” (Carmen, Reintegration Coach) She defined two types of patients. Those who are surprised by their actual capacity when performing the test, and those who are convinced of their incapacity. Both groups lack confidence in their own capabilities. Physiotherapists considered that low-back pain patients often stiffen their back and do not dare to move anymore for fear of pain. This complicates the choice for a certain therapy: “[…] you are still trying to get them in kind of a movement model […]” (Remy, Movement Therapist) and makes it difficult to prevent guarded movement in patients. One physiotherapist commented: “[…] Apparently they’ve learned from us not to move, assuming that it’s not good or dangerous.” (Robin, Physiotherapist) This movement behaviour, that was adopted by the patients in the past, makes patients more vulnerable rather than stronger. He also remarked that there is “[…] evidence that low-back pain isn’t a disease for the majority here.” (Robin, Physiotherapist) indicating, that most patients do not have musculoskeletal problems that explain their low back pain. However, one reintegration coach noted that she, in contrast, sees a lot of patients “[…] who perform lots of repetitive, physically demanding work, who do have mechanical problems […]” (Katy, Reintegration Coach)