Background & Aims
Low back pain is the number one cause of disability globally [1]. Social determinants of health influence low back pain and its outcome [2] particularly for people living in the low- and middle-income countries (LMICs) [3]. The Lancet Series of Low Back Pain highlighted the lack of low back pain data from LMICs [4]. The study aimed to describe (1) what low back pain care is currently delivered in LMICs, and (2) how that care is delivered.
Methods
An online mixed-methods study. A Consortium for low back pain in LMICs (n=65) was developed with an expert panel of leading low back pain researchers (>2 publications on low back pain) and multidisciplinary clinicians and patient partners with five years of clinical/lived low back pain experience in LMICs [3]. Quantitative data were analyzed using descriptive statistics. Two researchers independently analyzed qualitative data using deductive and inductive coding and developed a thematic framework.
Results
Forty-seven of 55 invited panel members (85%) representing 32 LMICs completed the survey (38% women; 62% men). The panel included clinicians (34%), researchers (28%), educators (6%), and patient partners (4%). Pharmacotherapies and electrophysiological agents were the most used low back pain treatments. The Thematic Framework comprised of eight themes: (1) Self-management is ubiquitous; (2) Medicines are the cornerstone; (3) Traditional therapies have a place; (4) Society plays an important role; (5) Imaging use is very common; (6) Reliance on passive approaches; (7) Social determinants influence low back pain care pathway; and (8) Health systems are ill-prepared to address low back pain burden.
Conclusions
Low back pain care in LMICs did not consistently align with the best available evidence. Findings will help research prioritization in LMICs and guide global low back pain clinical guidelines. The establishment of the Consortium will facilitate global collaboration to address the burden of low back pain worldwide especially in the resource-limited countries.
References
1.G. B. D. Low Back Pain Collaborators: Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol 2023, 5(6):e316-e329.
2.Karran EL, Grant AR, Moseley GL: Low back pain and the social determinants of health: a systematic review and narrative synthesis. Pain 2020, 161(11):2476-2493.
3.Sharma S, McAuley JH: Low Back Pain in Low- and Middle-Income Countries, Part 1: The Problem. J Orthop Sports Phys Ther 2022, 52(5):233-235.
4.Buchbinder R, van Tulder M, Oberg B, Costa LM, Woolf A, Schoene M, Croft P, Lancet Low Back Pain Series Working G: Low back pain: a call for action. Lancet 2018, 391(10137):2384-2388.
Presenting Author
Saurab Sharma
Poster Authors
Saurab Sharma
PT
University of New South Wales
Lead Author
Anupa Pathak
PhD
Lead Author
Romy Parker
University of Cape Town
Lead Author
Leonardo Oliveira Pena Costa
PhD
Lead Author
BABITA GHAI,MBBS
MD
Postgraduate Institute of Medical Education and Research Chandigarh
Lead Author
Chinonso Igwesi-Chidobe
PhD
Lead Author
Prawit Janwantanakul
PhD
Lead Author
Fabianna Resende de Jesus Moraleida - PhD
Federal University of Ceara
Lead Author
Mulugeta Bayisa Chala
PhD
Lead Author
Mohammadreza Pourahmadi
PhD
Lead Author
Andrew M. Briggs
PhD
Lead Author
Edward Gorgon
PhD
Lead Author
Clare L. Ardern
PhD
Lead Author
Karim M. Khan
PhD
Lead Author
James H. McAuley
PhD
Lead Author
saurab sharma
Lead Author
Topics
- Access to Care