IJPR.2025.150
Type of Article: Original Research
Volume 14; Issue 1 (April 2026)
Page No.: 4975-4981
DOI: https://dx.doi.org/10.16965/ijpr.2025.150
Attitudes and Beliefs of Indian Physiotherapist about Chronic Nonspecific Low Back Pain and Choices in Treatment Selection: A Questionnaire Based Cross Sectional Study
Abdur Rahman *¹, Ranjeeth Kumar C 2, Snehanjali Sahu 3.
*1 Master of Physiotherapy, Department of Physiotherapy, Yenepoya School of Allied and Healthcare Professions, Yenepoya (Deemed to be University), Bengaluru, Karnataka, India.
2 Assistant Professor, Department of Physiotherapy, Yenepoya School of Allied and Healthcare Professions, Yenepoya (Deemed to be University), Bengaluru, Karnataka, India.
3 Assistant Professor, Department of Occupational Therapy, Yenepoya School of Allied and Healthcare Professions, Yenepoya (Deemed to be University), Bengaluru, Karnataka, India.
Corresponding Author: Abdur Rahman, Master of Physiotherapy, Department of Physiotherapy, Yenepoya School of Allied and Healthcare Professions, Yenepoya (Deemed to be University), Bengaluru, Karnataka, India. E-Mail: rahmank2587774@gmail.com
ABSTRACT
Chronic low back pain (CLBP) is a leading cause of disability worldwide. While often managed using a biomedical model, current evidence supports the biopsychosocial approach. This study examined the attitudes and beliefs of Indian physiotherapists regarding non-specific CLBP (NSCLBP) using the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) and explored associations between belief orientation and treatment choices. Ninety-six physiotherapists from Bangalore, India, participated in a questionnaire-based cross-sectional survey. Data were collected via face-to-face interviews and analyzed using descriptive statistics, Pearson correlation, and logistic regression in SPSS v26 (p<0.05). Participants demonstrated moderate biomedical and strong biopsychosocial orientations. Stretching was universally practiced; other treatments varied. Higher biomedical scores predicted bed rest prescription, whereas stronger biopsychosocial orientation predicted use of the McKenzie method and cupping therapy. Findings suggest a blend of traditional and modern beliefs, with some reliance on outdated practices. Educational interventions promoting the biopsychosocial model may improve patient outcomes.
KEY WORDS: Attitudes, beliefs, biomedical orientation, biopsychosocial model, low back pain, physiotherapy.
REFERENCES
[1]. Alshehri MA, Alzahrani H, Alotaibi M, et al. Physiotherapists’ pain attitudes and beliefs towards chronic low back pain and their association with treatment selection: a cross-sectional study. BMJ Open. 2020;10(6):e037159.
https://doi.org/10.1136/bmjopen-2020-037159
PMid:32571864 PMCid:PMC7311013
[2]. Magalhães MO, Costa LO, Cabral CM, et al. Attitudes and beliefs of Brazilian physical therapists about chronic low back pain: a cross-sectional study. Rev Bras Fisioter. 2012;16(3):248-253.
https://doi.org/10.1590/S1413-35552012005000014
PMid:22481694
[3]. Latimer J, Maher C, Refshauge K, Colaco I. The attitudes and beliefs of physiotherapy students to chronic back pain. Clin J Pain. 2004;20(1):45-50.
https://doi.org/10.1097/00002508-200401000-00009
PMid:14668656
[4]. Darlow B, Perry M, Stanley J, et al. Cross-sectional survey of attitudes and beliefs about back pain in New Zealand. BMJ Open.2014;4(5):e004725.
https://doi.org/10.1136/bmjopen-2013-004725
PMid:24859999 PMCid:PMC4039787
[5]. Bishop A, Foster NE, Thomas E, Hay EM. How does the self-reported clinical management of patients with low back pain relate to the attitudes and beliefs of health care practitioners? A survey of UK general practitioners and physiotherapists. Pain. 2008;135(1-2):187-195.
https://doi.org/10.1016/j.pain.2007.11.010
PMid:18206309 PMCid:PMC2258319
[6]. Christe G, Nzamba J, Gobelet C, et al. Physiotherapists’ attitudes and beliefs about low back pain influence their clinical decisions and advice. Musculoskelet Sci Pract.2021;53:102382.
https://doi.org/10.1016/j.msksp.2021.102382
PMid:33915318
[7]. Alamam DM, Leaver A, Refshauge K, et al. Pain Behaviour Scale (PaBS): An exploratory study of reliability and construct validity in a chronic low back pain population. Pain Res Manag. 2019;2019:2508019.
https://doi.org/10.1155/2019/2508019
PMid:30863470 PMCid:PMC6377952
[8]. Pottkotter K, Hazlett M, Mansfield C, Ford K, Rethman K, Fritz J, et al. Understanding social determinants of health and physical therapy outcomes in patients with low back pain: a scoping review protocol. Musculoskeletal Care. 2022;20(4):531-539.
https://doi.org/10.1002/msc.1650
[9]. Jeffrey JE, Foster NE, Choy EH. A qualitative investigation of physical therapists’ experiences and feelings of managing patients with nonspecific low back pain. Phys Ther. 2012;92(2):266-278.
https://doi.org/10.2522/ptj.20100416
PMid:22173793
[10]. Corbett M, Foster N, Ong BN. GP attitudes and self-reported behaviour in primary care consultations for low back pain. Fam Pract. 2009;26(4):359-364.
https://doi.org/10.1093/fampra/cmp039
PMid:19535736
[11]. Askew R, Kibelstis C, Overbaugh S, et al. Physical therapists’ perception of patients’ pain and its effect on management. Physiother Res Int. 1998;3(1):37-57.
https://doi.org/10.1002/pri.128
PMid:9648174
[12]. Rainville J, Bagnall D, Phalen L. Health care providers’ attitudes and beliefs about functional impairments and chronic back pain. Clin J Pain. 1995;11(4):287-295.
https://doi.org/10.1097/00002508-199512000-00009
PMid:8788579
[13]. Ostelo RWJG, Stomp-van den Berg SGM, Vlaeyen JWS, Wolters PMJC, de Vet HCW. Health care providers’ attitudes and beliefs towards chronic low back pain: the development of a questionnaire. Man Ther. 2003;8(4):214-222.
https://doi.org/10.1016/S1356-689X(03)00013-4
PMid:14559044
[14]. Bishop A, Foster NE, Croft PR. The Pain Attitudes and Beliefs Scale (PABS): further validation and development of a short form. J Physiother. 2010;56(4):279-286.
https://doi.org/10.1016/S1836-9553(10)70014-X
PMid:21213945
[15]. Darlow B, Fullen BM, Dean S, Hurley DA, Baxter GD, Dowell A. The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: a systematic review. Eur J Pain. 2012;16(1):3-17.
https://doi.org/10.1016/j.ejpain.2011.06.006
PMid:21719329
