Evaluating Nurses’ Understanding of Lower Back Pain and Approaches for Physical Therapy

• Mahfoudh Falih Hasan

  College of Nursing University of Basra

• Firas Hadi Khalaf

  College of Nursing University of Basrah

• Maher Abdul Ameer Atiyah

  College of Nursing University of Basrah

• Mohammed Kadhim Mutashar

  College of Nursing University of Basrah

Low back pain (LBP) is a widespread condition negatively impacting quality of life and productivity. Nurses play a vital role in managing LBP, especially through the application of physiotherapy techniques. This study aimed to assess nurses' perception levels regarding LBP and physiotherapy exercises. A descriptive cross-sectional study was conducted in Basra hospitals between May and August 2024, involving 80 nurses. Data were collected using a 24-items structured questionnaire covering general perception and exercise therapy, rated on a 3-point Likert scale. Perception levels were categorized as poor, medium, or good. The majority of participants (62.5%) were female. Overall, 58% demonstrated medium perception, followed by 37% with good perception and 5% with poor perception. In part-specific analysis, 83% scored well in general perception, while 72% passed the exercise therapy section. The mean scores were 14.82 ± 3.62 and 13.70 ± 4.33, respectively. No significant associations were found between demographic variables and perception levels. The findings indicate a need for targeted educational programs to enhance nurses’ competence in physiotherapy-based LBP management.

Highlights:

1. More than half of the nurses (58%) demonstrated a medium perception level regarding lower back pain and physiotherapy management.
2. Higher understanding was observed in general knowledge (83% passed) than in exercise therapy (72% passed).
3. The study emphasizes the need for targeted educational programs to improve nurses’ competence in physiotherapy-based pain management.

[1] National Institute of Neurological Disorders and Stroke, “Low Back Pain Fact Sheet,” published Nov. 3, 2015.

[2] N. Chitale Jr., D. S. Patil, P. Phansopkar, A. Joshi, N. V. Chitale, and D. S. Patil Sr., “A review on treatment approaches for chronic low back pain via Mulligan’s movement with mobilization and physical therapy,” Cureus, vol. 14, no. 8, Aug. 18, 2022.

[3] B. W. Koes, M. V. Tulder, C. W. Lin, L. G. Macedo, J. McAuley, and C. Maher, “An updated overview of clinical guidelines for the management of non-specific low back pain with primary care,” Eur. Spine J., vol. 19, no. 12, pp. 2075–2094, 2011.

[4] V. Ghavipanje, N. M. Rahimi, and F. Akhlaghi, “Six weeks effects of dynamic neuromuscular stabilization (DNS) training in obese postpartum women with low back pain: A randomized controlled trial,” Biol. Res. Nurs., vol. 24, no. 1, pp. 106–114, Jan. 2022.

[5] L. da C. M. Costa, C. G. Maher, M. J. Hancock, J. H. McAuley, R. D. Herbert, and L. O. Costa, “The prognosis of acute and persistent low back pain: A meta-analysis,” CMAJ, vol. 184, no. 11, pp. E613–E624, 2012.

[6] A. Mosabbir, “Mechanisms behind the development of chronic low back pain and its neurodegenerative features,” Life, vol. 13, no. 1, p. 84, Dec. 28, 2022.

[7] B. A. Casazza, “Diagnosis and treatment of acute low back pain,” Am. Fam. Physician, vol. 85, no. 4, pp. 343–350, 2012.

[8] S. Chen, M. Chen, X. Wu, S. Lin, C. Tao, H. Cao, Z. Shao, and G. Xiao, “Global, regional and national burden of low back pain 1990–2019: A systematic analysis of the Global Burden of Disease Study 2019,” J. Orthop. Transl., vol. 32, pp. 49–58, Jan. 2022.

[9] E. G. Manusov, “Evaluation and diagnosis of low back pain,” Prim. Care, vol. 39, no. 3, pp. 471–479, 2012.

[10] S. P. Cohen, E. J. Wang, T. L. Doshi, L. Vase, K. A. Cawcutt, and N. Tontisirin, “Chronic pain and infection: mechanisms, causes, conditions, treatments, and controversies,” BMJ Med., vol. 1, no. 1, p. e000108, Mar. 31, 2022.

[11] L. Salzberg, “The physiology of low back pain,” Prim. Care, vol. 39, no. 3, pp. 487–498, 2012.

[12] S. Z. George et al., “Interventions for the management of acute and chronic low back pain: Revision 2021: Clinical practice guidelines linked to the International Classification of Functioning, Disability and Health from the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association,” J. Orthop. Sports Phys. Ther., vol. 51, no. 11, pp. CPG1–CPG60, Nov. 2021.

[13] D. Hoy, C. Bain, G. Williams, L. March, P. Brooks, and F. Blyth, “A systematic review of the global prevalence of low back pain,” Arthritis Rheum., vol. 64, no. 6, pp. 2028–2037, 2012.

[14] M. U. Rahaman, “Risk factors of Prolapsed Lumbar Intervertebral Disc (PLID) among the low back pain patients attended at CRP: A case control study,” Doctoral dissertation, Bangladesh Health Professions Institute, Faculty of Medicine, University of Dhaka, Bangladesh, 2012.

[15] T. Vos, A. D. Flaxman, M. Naghavi, R. Lozano, C. Michaud, and M. Ezzati, “Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010,” Lancet, vol. 380, no. 9859, pp. 2163–2196, 2012.

[16] M. Leysen et al., “Attitudes and beliefs on low back pain in physical therapy education: A cross-sectional study,” Braz. J. Phys. Ther., vol. 25, no. 3, pp. 319–328, May 2021.