Limited access to evidence-based information and ineffective treatment modalities, especially in low- and middle-income countries, may contribute to the increase in years lived with disability associated with low back pain. Added to this, early referral to more complex levels of care increases waste and hinders this population's equitable access to health services.

To describe low back pain treatment strategies in primary care from the user's perspective and their satisfaction with the treatment.

This is a cross-sectional and descriptive study. A structured interview was carried out with consumers with low back pain in primary health care, from February to April 2023 in six Health Units in Fortaleza/Brazil. The study followed ethical criteria. Data about pain intensity (Numerical Rating Scale - NRS) and disability (Roland Morris Disability Questionnaire - RMDQ) in the last month were collected. Information about low back pain treatment strategies by the primary care health professional, including pharmacological and non-pharmacological treatment, and consumer satisfaction with the treatment and the reasons were investigated.

Fifteen consumers with a mean age of 54 (±10) years participated, most of them female (86%) and who reported feeling pain for more than 3 months (100%). These consumers had 16 (±5) points on the RMDQ, and 8 (±1) points on the NRS in the last month. In total, 86% of consumers were advised to use analgesic, anti-inflammatory and/or muscle relaxant medication, 66% to perform therapeutic exercises; 53% were referred for imaging, 46% were referred for physiotherapy; 26.7% were referred to a specialist physician, 13.3% received health education, and 6.7% were referred for surgery. Only 46% of consumers reported satisfaction with the treatment, listing the friendliness of the professional, prescription of medication and imaging tests as the main factors. The absence of a pain solution and medication prescription, in addition to the quality of professional care, were the main reasons for consumers' dissatisfaction.

Most treatment strategies proposed by primary care health professionals are not in accordance with guidelines for low back pain management. Most consumers reported that the treatment was not effective, and this contributed to dissatisfaction.

Strategies that bring primary care professionals and consumers with low back pain closer to evidence-based low back pain management recommendations can help in a more effective treatment that promotes consumer satisfaction.