Management of low back pain: a survey of physical therapists' adherence to clinical practice guidelines in the State of Kuwait

Background/Aims Physical therapy clinical practice guidelines for the management of low back pain are accessible to most physical therapists in the State of Kuwait. However, guideline adherence remains undocumented. The aims of this study were to describe the low back pain treatment interventions and adherence to clinical practice guidelines by physical therapists in the State of Kuwait. Methods A total of 200 questionnaires were distributed to a convenience sample of physical therapists working in governmental hospitals who treat a variety of neuro-musculoskeletal conditions. The questionnaire contained questions on patients and the treatments applied. Physical therapists with less than 1 year of clinical experience were excluded. Descriptive and inferential statistics (analysis of variance) were used. Results Overall, 132 physical therapists completed the questionnaire (response rate of 66.0%). One-third of physical therapists' caseloads included 40-50% of patients with low back pain. Physical therapy treatments most commonly included non-evidence-based treatment, such as superficial heat, interferential therapy and transcutaneous electrical nerve stimulation. Evidence-based treatment, such as exercises and passive stretching techniques, were less frequently used. There was no significant difference between the physical therapists' years of experience, education or place of work and their treatment of choice. Conclusions Some physical therapists in the State of Kuwait deviate from clinical practice guidelines and use non-evidence-based treatment instead of evidence-based treatment in the management of low back pain. Therefore, intensive training and revision to current treatment protocols are required.