Purpose. To explore which factors lead to tension in the patient-physician interaction in the first consultation by rehabilitation physicians of patients with chronic non-specific low back pain of Turkish and Moroccan origin. Method. In-depth semi-structured, face to face interviews were conducted with 12 patients of Moroccan and Turkish origin and four native Dutch rehabilitation physicians. Interviews were transcribed and/or summarised. All interviews were subsequently coded and analysed according to themes. Results. Factors that lead to tension in the patient-physician interaction were as follows: differences in expectations regarding the aim of treatment, symptom presentation, views on responsibilities with regard to rehabilitation treatment, lack of trust, contradicting views of physicians from patients' country of origin with regard to the cause and treatment of pain and communication problems. Conclusion. Sources of tension were identified during the interaction between Dutch physicians and patients of Turkish and Moroccan origin. These factors potentially are associated with future drop-out. Future research should clarify whether these factors indeed are associated with drop-out. © 2009 Informa UK Ltd All rights reserved.