Cross-sectional analysis of online information on low back pain across South African chiropractic websites

Rising low back pain (LBP) prevalence and increased patient reliance on online health resources necessitate critically evaluating how chiropractic websites represent common musculoskeletal conditions. This study analyzed LBP-related content shared by South African chiropractic websites to assess the credibility of available information.

A cross-sectional content evaluation was conducted between 2 June 2024 and 21 July 2024 on 333 South African chiropractic websites, identified using a Google search cross-referenced with the Allied Health Professions Council of South Africa registry. Four key areas were evaluated, including (1) contributors to, (2) diagnostic approaches for, (3) possible treatment approaches for and 4) indicators for seeking professional treatment for LBP. Sociodemographic factors such as educational background, sex, and practice ownership structure were considered. A pilot ensured data collection standardization. Content and statistical analysis explored information, citation frequency and identified trends in chiropractic online health communication.

The analysis revealed significant variability of LBP-related content across chiropractic websites. Of the 333 websites analyzed, most chiropractors were trained at UJ (58.1%) and DUT (29.2%). Sex distribution showed 55.3% were female-owned. The highest concentration of chiropractic websites was in Gauteng, the Western Cape, and KwaZulu-Natal. Regarding the 4 key areas, mechanical contributors to LBP were predominant (65.2%), diagnostic approaches (56.7%), treatment approaches (79.6%) and explicit guidance on when to seek care (47.4%) was mentioned in the websites. Only 13.5% of websites cite sources of the information shared. Chiropractors trained at UJ and DUT emphasized evidence-based treatments, while those trained internationally referenced alternative methods. Sex differences showed males focusing on diagnostic tools and treatment protocols, while females emphasized holistic care and lifestyle modifications.

This study highlights the need for improved LBP information quality and consistency on South African chiropractic websites. The structured subjective content evaluation revealed notable gaps in content depth, specificity, and evidence-based citations. Sociodemographic factors, including educational background and sex, influenced the presentation of information. Future research should prioritize developing standardized and evidence-based guidelines for chiropractic websites to improve access to online health information and patient education and ensure accurate, reliable health information delivery.