Current Physiotherapy Assessment and Treatment Practices for Low Back Pain in Nigeria: A National Survey.

Introduction: Despite advances in physiotherapy care for Low Back Pain (LBP) worldwide, studies suggest that physiotherapists in Nigeria do not adhere to international guidelines, and it is not known whether recent treatment approaches developed for LBP are recognized or applied by physiotherapists in Nigeria.

Objectives: To evaluate the current assessment and treatment practices used by physiotherapists in Nigeria for people with recent onset, recurrent and chronic LBP.

Design: A descriptive cross-sectional electronic national survey.

Participants: Two hundred and sixty-seven registered physiotherapists who treat LBP across all 36 states of Nigeria completed the survey anonymously via REDCap.

Results: Two hundred and sixty-seven physiotherapists (mean age = 37.6 years, SD = 9.1; 53.6% female) completed the survey in full. Although most physiotherapists (> 95%) regularly applied traditional assessment methods (e.g., history of presenting complaint, observation for spinal deformity, palpation), only approximately 30% screened for red flag pathology. Very few physiotherapists assessed patients with LBP for psychological distress (< 8%) or risk stratification/prognostic factors (< 4%). For treatment, electrophysical agents and muscle techniques (e.g., massage) predominated (> 95%), while few physiotherapists used cognitive-behavioural strategies (< 2%), individualised multimodal treatment programs (e.g., cognitive functional therapy, StarT Back or STOPS, < 1.5%), validated outcome measures (< 15%), clinical practice guidelines (< 10%) or a clinical reasoning strategy/framework (< 20%). Most Nigerian physiotherapists (> 99%) expressed interest in learning evidence-based LBP assessment and treatment methods from international experts.

Conclusion: There is very limited application of contemporary assessment and treatment practices for LBP by Nigerian physiotherapists; however, they are very interested in learning these methods from international experts.