A Narrative Review on Physiotherapy Management of Back Pain

Yusuff Tunde Gbonjubola, 1 Harrison Toluwanimi Adetunji2  

• 1Department of Physiotherapy, Abubakar Tafawa Balewa University Teaching Hospital
• 2Department of Physiotherapy, Sports Medicine Centre, Moshood Abiola National Stadium, Abuja 
•  

Correspondence

Yusuff Tunde Gbonjubola, Department of Physiotherapy, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria. Email [email protected] 

Received: November 21, 2023                                                                                                              Published: December 12, 2023 

Citation :Gbonjubola YT. A Narrative Review on Physiotherapy Management of Back Pain. AOJ Emerg and Int Med. 2023;1(2):09–17.

 Copyright: ©2023 Gbonjubola. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially.

Abstract 

Low back pain (LBP) is a prevalent and multifaceted musculoskeletal condition impacting a vast population globally. It presents with a spectrum of symptoms and varied etiologies, leading to significant disability and healthcare burden. This paper explores the multifactorial nature of LBP, diagnostic procedures, prevention strategies, and management options. Diagnosis of LBP largely hinges on a thorough physical examination and selective use of diagnostic imaging when specific or severe conditions are suspected. Prevention strategies are categorized by primary, secondary, and tertiary interventions, focusing on education, physical exercise, and avoidance of non-beneficial supportive devices. Management encompasses a multidisciplinary approach including medical treatment, surgical intervention for selected cases, physiotherapy, and psychosocial support. The role of physiotherapy is highlighted in offering patient education, exercise therapy, manual therapy, and electrotherapy modalities, all tailored to individual needs. This integrative review underscores the necessity of a personalized and evidence-based approach to LBP to optimize outcomes and enhance quality of life for sufferers. 

Keywords: low back pain, physiotherapy, myofascial syndrome, spondylolisthesis

Definition and General Overview of Back Pain

 Pain refers to an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.1 Typically, Low back pain (LBP) is described as pain, muscle tension or stiffness that originates below the costal border and extends above the inferior gluteal fold, and may be accompanied with referred leg pain.2,3 It is a debilitating musculoskeletal condition associated with disability and work absence. Which is responsible for elevated healthcare and economic costs globally.4 During the second half of the twentieth century, low back pain became one of the most pressing issues for public health systems in the Western world , and it now appears to be spreading globally.5 Most people will experience back pain at some point in their life.6 Intervertebral discs, facet joints, sacroiliac joints, muscles, fascia, bones, nerves, and meninges are all local origins of LBP.7 While Herniated discs, osteoarthritis, myofascial syndrome, spondylolisthesis, ankylosing spondylitis, rheumatoid arthritis, fibrosis, arachnoiditis, tumor, and infection are all causes of low back pain. The incidence of spinal disorders is high, especially those associated with poor posture, inappropriate body movements, and occupational factors that can injure the spine.8

Classification of Low Back Pain 

Low back pain can be broadly classified into two. Namely: based on its specificity and the other based on time duration from its onset. Based on specificity, LBP is further classified into non-specific low back pain and specific low back pain. Non-specific low back pain (NSLBP) refers to pain as a result of no recognizable or serious pathology such as fracture, cancer, inflammatory diseases or nerve root compromise while specific low back pain refers to pain which is a result of a recognizable or serious cause of pathology.9,10 Most LBP are non-specific as a definitive diagnosis is usually not met with current radiological investigations.11 Based on low back pain time duration since onset is classified as acute, sub-acute and chronic. Acute low back pain is LBP which has lasted for less than 6 weeks, sub-acute low back pain is an episode between 6 and 12 weeks with chronic low back pain lasting over 12 weeks.12 Studies indicate that, 85% of patients seen by physiotherapists are diagnosed with NSLBP with 10-40% of the cases established as chronic NSLB.10,13