TODAY, September 8, we join the global community in commemorating World Physiotherapy Day. This year’s topic, low back pain (LBP), highlights a condition that is not just the most significant cause of disability globally but also a major public health problem.

With approximately 619 million individuals suffering with LBP in 2020—one in every 13 people—the World Health Organization (WHO) predicts that this condition will impact 843 million people by 2050, a 60 per cent increase from 1990. These statistics highlight the critical need to address this widespread issue. As we celebrate this significant day, it is critical to highlight the significance of physiotherapy for managing and reducing LBP.

Low back pain is a pervasive issue in Jamaica, affecting people of all ages. While local statistics are lacking, studies have shown that musculoskeletal disorders, including LBP, are common in the Jamaican population. In a 2016 study, 50 per cent of the participants reported experiencing back pain in the previous year, placing a significant burden on the healthcare system and diminishing their quality of life. The Jamaican healthcare system, like many others, grapples with managing chronic conditions such as LBP. However, it also presents opportunities for innovative solutions, such as expanding access to physiotherapy services beyond secondary care.

Understanding low back pain

Most people will have LBP at some time in their lives. Fortunately, most LBP is acute and resolves within a few weeks. However, in some cases, it becomes chronic, lasting more than three months. Notably, 90 per cent of LBP cases are non-specific, meaning no particular structure—such as a joint, muscle, ligament, or disc—can be pinpointed as the cause. This often leads to unnecessary imaging and treatments despite evidence that even the most sophisticated scans cannot conclusively identify the cause of most chronic back pain.

While many people recover from LBP with little to no intervention, if you have ongoing lower back pain for more than two to three weeks, or if it worsens and affects daily activities, or if the pain persists for six weeks, even if everyday activities can still be completed, consult a doctor or physiotherapist. Seek early intervention to prevent LBP from becoming chronic. Watch for red flags such as bladder/bowel issues, impaired sexual function, leg weakness, or fever with back pain. If you are over 50 with a cancer history and unexplained back pain, seek immediate medical attention. Trauma-related back pain needs prompt assessment.

The role of physiotherapy in managing low back pain

Physiotherapists are experts in treating LBP and offer personalised care. In 2015, a friend who was a healthcare worker always complained about LBP. Initially, he was not referred to physiotherapy but decided to pursue it after learning about its benefits. After a few sessions, he was free of pain and given the tools he needed to care for his back and prevent its recurrence. This is just one example of many in our communities demonstrating how important it is to raise awareness of valuable treatments like physiotherapy. More crucially, it emphasises the importance of a multidisciplinary approach to healthcare, in which various healthcare specialists collaborate to provide comprehensive management.

Physiotherapy is not just about exercise; it is about empowering individuals to live without physical limitations. Treatment sessions are comprehensive and diverse, focusing on patient education and lifestyle management to ensure a deep understanding of LBP and effective self-management strategies. Physiotherapists prescribe individualised exercise plans tailored to each patient, supervised and designed to improve strength and facilitate a return to physical activity. Effective physiotherapy interventions emphasise self-management, reducing patients’ dependence on healthcare providers. This approach is particularly crucial for chronic LBP, where prolonged rest and inactivity can be counterproductive. Instead, movement, confidence, and a gradual return to normal activities are essential for recovery.

Common myths and misconceptions about low back pain

LBP and misconceptions are almost synonymous, and this can hinder effective management.

A prevalent misconception is that a scan or X-ray is required to diagnose what is wrong with the back. Scans seldom show the source of LBP. Common findings, such as disc bulges or degeneration, are typically normal, especially with age, and can be detected in people not in pain.

Furthermore, a weak core does not induce LBP, despite the belief held by many that several core exercises are necessary to prevent LBP. Research indicates that general exercise, like walking, is just as beneficial as targeted core workouts for reducing pain and impairment.

There is also a misconception that something is wrong if you have back pain when exercising. In actuality, the back—which is robust and able to move and load safely—benefits from movement and exercise. Moving less might exacerbate the problem by causing fear and overprotection.

Finally, the concept that poor posture causes back pain and that one must sit straight is unfounded. There is no single “perfect” posture; altering postures throughout the day is good, and the objective is to find comfortable and relaxed positions.

Moving forward: The need for accessible physiotherapy services to empower change

The longer an individual experiences LBP, the more likely they will face limitations in their daily activities. Physiotherapy offers a comprehensive approach to LBP management, addressing the physical aspects and the psychological and social factors that contribute to the condition. By adopting a biopsychosocial approach, physiotherapists can create compelling, personalised interventions that support recovery and help individuals return to the activities they enjoy.

As we celebrate World Physiotherapy Day, I challenge us to become more patient-centred and to provide more access to proven interventions. This includes policymakers’ roles in lobbying for and implementing policies to improve access to physiotherapy services. LBP is treatable, and no one should feel hopeless or powerless. Let us use this opportunity to improve the lives of individuals affected by LBP and ensure that physiotherapy services are available to everyone who requires them.

Offniel Lamont is a public health advocate and registered physiotherapist with an MSc in sports medicine, exercise, and health. He is passionate about promoting preventive measures for sports injuries, particularly among junior athletes, and combating non-communicable diseases through developing public policies supporting comprehensive sports and healthcare management.