Analysis Of Preferred Manual Techniques For Low Back Pain Among Orthopedic Physiotherapists Practitioners

Abstract

BACKGROUND -Low back pain (LBP) is a leading cause of disability globally, with up to 80% of people experiencing it in their lifetime. In India, LBP is a common issue treated conservatively by orthopedic physiotherapists using various manual therapy techniques, including myofascial release, mobilization, manipulation and neural mobilization. There is continually emerging evidence supporting these various methods; however, clinical practice can be very different due to variable education, experiences, institutional practices, and patient factors. There is a considerable separation between guideline level evidence and real-world practice, with the majority of physiotherapists using habitual or experiential methods. Understanding what manual techniques are currently being used will enable identification of trends, inform clinical decision making and improve compliance with best practice. The overall aim of this study is to determine the manual techniques preferred by orthopedic physiotherapists in India when treating LBP, as well as investigate the factors informing their use.

OBJECTIVE-1.The most commonly employed manual therapy methods, favored by orthopedic physiotherapists to manage low back pain in India

1. Evaluation of factors determining the choice and efficacy of these techniques in clinical practice.

METHODOLGY-This study is an analytical, observational research conducted in India over a period of 9 months. The sample size was calculated using the formula n = Z²PQ / L², resulting in a total of 75 participants. A convenient sampling technique was employed to recruit participants. The primary outcome measure was obtained through a self-filled questionnaire designed to capture data relevant to the study objectives.

RESULT- This study analyzed preferred manual therapy techniques for low back pain among 75 orthopedic physiotherapists in India. Most participants were young (ages 27–28) and female (77.3%), with varied experience levels. The most used techniques were myofascial release (33.3%), mobilization (22.7%), and overall soft tissue methods (41.3%). Nearly all therapists (98.7%) used a multimodal approach, guided mainly by clinical findings (48%) and pain intensity (44%).A majority practiced in hospitals (57.3%), primarily in Mumbai, Thane, and Pune, treating 5–10 LBP patients weekly. Sessions typically lasted 10–20 minutes, with most reporting improvements in pain and function. While 48% had workshop-based certifications, only 56% had advanced training. There was interest in techniques like McKenzie, dry needling, and IASTM. Barriers included patient compliance (52%), time, and technique difficulty.

CONCLUSION- This research illustrates the current trends in practice patterns of orthopedic physiotherapists in managing low back pain, highlighting a strong inclination toward the use of soft tissue techniques, namely myofascial release and mobilization. Most clinicians note a preference for a multidisciplinary or multimodal and patient-centered approach, influenced by their clinical findings and pain numbers. Overall, the sample consisted mainly of predominantly female, younger, early career physiotherapists with different addons and levels of training, some of which indicated interest in additional training or education to learn more advanced techniques. While they expressed positive perceptions about efficacy, the challenges with manual therapy intended for patients still existed, such as patient compliance, time limitations, and difficulty implementing into practice. Overall the study highlights a gap in standardized training, but also the necessity for additional research in clinical settings to create that bridge between best evidence and clinical practice.