How Low Back Pain is Managed-A Mixed-Methods Study in 32 Countries. Part 2 of Low Back Pain in Low- and Middle-Income...

Area of Science:

• Global Health
• Musculoskeletal Disorders
• Health Services Research

Background:

• The Lancet Low Back Pain Series identified a scarcity of data on low back pain (LBP) in low- and middle-income countries (LMICs).
• Existing LBP care models may not be suitable for LMIC contexts.
• Understanding current LBP management is crucial for developing targeted interventions.

Purpose of the Study:

• To characterize the current landscape of low back pain (LBP) care delivery in LMICs.
• To identify the specific treatments and modalities utilized for LBP in these regions.
• To explore the methods and approaches employed in managing LBP within LMICs.

Main Methods:

• An online mixed-methods study involving a Consortium for LBP in LMICs.
• An expert panel (n=65) comprised of LBP researchers, clinicians, and patient partners from LMICs.
• Quantitative survey data analyzed descriptively; qualitative data analyzed thematically.

Main Results:

• Pharmacotherapies and electrophysiological agents were the most common LBP treatments.
• Key themes included ubiquitous self-management, reliance on medicines, use of traditional therapies, societal influence, common imaging use, passive treatment preference, impact of social determinants, and health system unpreparedness.
• Care often deviated from evidence-based recommendations.

Conclusions:

• Low back pain care in LMICs frequently diverges from best-practice evidence.
• Findings underscore the need for LBP research prioritization within LMICs.
• Results will inform global LBP clinical guidelines and improve care delivery in resource-limited settings.