Exploring self-management of chronic low back pain in Saudi Arabia

Aim: The main purpose of this research project is to explore both patients’ and physiotherapists’ perceptions and understanding of self-management for chronic low back pain (CLBP) in the Kingdom of Saudi Arabia (KSA) and moreover, to explore current physiotherapy practice for managing CLBP in KSA. Methods: This research project used a mixed methods approach with sequential designs. The first section contains a quantitative study and the second section includes two qualitative studies. The quantitative section allowed exploration of current physiotherapy practices for CLBP management using a large population. The qualitative section has provided a more in-depth understanding of both patients' and physiotherapists' perceptions in regards to self-management and physiotherapy management for CLBP. Results: In the current study, physiotherapists acknowledged the importance of exercise and advice. Moreover, these represented the most common treatment methods used in daily practice. However, patients’ preferences for passive approaches, such as rest, massage and modalities were frequently reported. This shows conflict between physiotherapists and patients with CLBP in terms of the preferred approach for managing the disorder. Physiotherapists’ extensive use of modalities where evidence of effectiveness was lacking or insufficient was a common practice for physiotherapy management in patients with CLBP in the current research project. Moreover, physiotherapists and patients showed limited understanding of self-management as a concept. Conclusion: Promoting self-management in daily physiotherapy practice appears to be a complex issue. It involves various factors, such as promoting an evidence-based practice culture among physiotherapists; a patient-centred approach; access to guidelines and evidence; and organisational support through developing policy, local guidelines and CPD training. This research presents a platform of recommendations for future researchers, professionals, educators and policymakers to enhance the quality of care for patients with CLBP in the KSA in general and may increase the adoption of self-management.