Introduction
Low back pain (LBP) is the greatest cause of disability in the low- and middle-income countries (LMICs). To develop and optimise LBP care, research on the current models of LBP care, i.e., ‘what’ care is currently being provided and ‘how’ this care is being delivered is critical but currently lacking for LMICs. The aim of the paper is to describe how LBP is currently being delivered in LMICs and how.
Methods
A Consortium of LBP in LMICs was developed with 65 members from 35 LMICs. Fifty five members were invited to complete an online survey with closed and open-ended questions. Questions included top three commonly delivered treatments for acute and chronic LBP; primary setting where acute/chronic LBP is typically managed; first contact professional who manage LBP in each country.
Results
Fourty nine members from 32 countries responded to the survey. Pharmacotherapies and electrotherapies are the most common management approaches for both acute and chronic LBP, followed by thermotherapy and manual therapy for acute LBP, and active therapies (exercise) and interventional pain management approaches for chronic LBP. Acute LBP is typically managed in primary care settings and chronic LBP is typically managed in tertiary care settings. General physicians, orthopaedic surgeons, physiotherapists and traditional healers are commonly involved in LBP management. Qualitative data reveal that self-management was commonly used in many countries by people with LBP as the first treatment, however, it is not frequently prescribed by treating clinicians. Variability in how low back pain is managed within and between countries exists.
Discussion and conclusions
The findings provide interesting insights on LBP care in 32 LMICs which can serve as a foundation for developing LBP models of care for these countries. The Consortium can be used as a platform for sharing research expertise and resources for future research on LBP in LMICs.