Specialized Physiotherapy and Pharmacological Management Strategies in Optimizing Chronic Lower Back Pain Rehabilitation

Shazal Kumar Das¹, Abid Hasan Khan², Muhammad Shahidul Islam³, Nadira Alam⁴, Md. Nesaruddin⁵, Md. Jonaied Alam⁶, Tanvir Rahman⁷, Afroza Alam Shawon⁸, Proshoun Rakshit Himel⁹, Md. Anowar Khasru Parvez ¹⁰*

Specialized physiotherapy demonstrated superior outcomes in pain reduction and functional improvement compared to conventional NSAID treatment in Bangladesh.

Abstract

Background: Low back pain (LBP) is a prevalent health concern globally, posing significant challenges for prevention and treatment. This study addressed the pressing need for effective interventions for chronic lower back pain (CLBP), aiming to compare the efficacy of unique physiotherapy techniques, conventional physiotherapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) in alleviating symptoms and improving functional outcomes. Methods: Sixty-five patients with CLBP were enrolled in a randomized controlled trial conducted at the Centre for the Rehabilitation of the Paralysed (CRP) in Bangladesh. Participants were assigned to receive either a specific physiotherapy regimen or conventional physiotherapy with NSAID medication. Pain intensity and disability were measured using the Numerical Pain Rating Scale and Oswestry Disability Index, respectively. Results: Both treatment groups experienced significant reductions in pain intensity and disability scores post-intervention (p < 0.01). However, the group receiving specialized physiotherapy exhibited greater improvements compared to the conventional therapy with NSAIDs group. Socio-demographic characteristics indicated that participants were predominantly married individuals aged 31-44, with varying educational backgrounds and employment statuses. Notably, specialized physiotherapy interventions focusing on core stability, strengthening, stretching, posture, and core muscle activation demonstrated superior outcomes in reducing pain intensity, improving functional activity, and enhancing flexibility. Conclusion: Specialized physiotherapy interventions showed superior efficacy over conventional physiotherapy combined with NSAIDs in alleviating pain and improving functional outcomes in individuals with CLBP. Core stability exercises and targeted physiotherapy approaches appear to offer promising benefits for managing chronic low back pain, underscoring the importance of tailored rehabilitation strategies in clinical practice.

Keywords: Chronic lower back pain, physiotherapy, NSAIDs, treatment efficacy, Bangladesh

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