Adherence to Key Domains by Indian Physiotherapists in Low Back Pain Clinical Guidelines: A Narrative Review

Abstract

Low back pain (LBP) is one of the most common musculoskeletal problems in rest of the world which causes disability, work absenteeism, and use of medical services. The therapeutic management of acute as well as chronic LBP seems to vary substantially among medical specialists and physical therapists, but there is also considerable variation in the management of LBP between countries. This narrative review investigates an adherence to clinical practice guideline (CPG) for LBP among Indian physiotherapists regarding key domains. We identified studies by using the PubMed database in August 2022 using keywords “low back pain” and “Clinical Practice Guidelines.” Twenty-five articles were found and articles available on full text and study years between 2012 and 2022 were selected as inclusion criteria. Overall, physiotherapists are aware of CPGs and find it challenging to implement. Many studies showed an overall low adherence to the CPG, but adherence was best when LBP is associated with red flags. In public sector, physiotherapists were more likely to be strictly in line with the CPGs for assessing the psychosocial risk factors. Consideration of psychosocial parameters in treatment might have contributed to an increased awareness of strengths and weaknesses and a motivation to change routine practice in the management of patients with LBP.