Management of low back pain in Ghana : a survey of self-reported practice

Background and Purpose: Practice variation exists in the physiotherapy management of low back pain (LBP) across several countries. Previous studies indicate that treatment strategies used may not always be in line with evidence-based practice. Most of these studies however were conducted in developed countries. This study sought to investigate the management of LBP in Ghana in order to add to the emergent literature regarding practice in developing nations. Methods: A web-based self-report questionnaire was made available to all eligible members of the Ghana Physiotherapy Association. Results: The survey achieved a response rate of 67%. Over 60% of physiotherapists in Ghana had less than 5years of practice experience, worked in large facility hospitals and had no post-graduate further training. Most LBP patients seen were chronic, and over 60% of treatment sessions used multiple therapies and included exercises, advice, massage, electrotherapy and manual therapy. Conclusion: This first mapping of physiotherapy management of LBP in Ghana shows an overt multimodal approach. There was potential good practice with the high use of exercise and advice, the equally high utilization of passive treatments however showed variance to recommendations of guidelines. The findings of this study have implications for clinical practice and physiotherapy education and research.