Perceptions of Low Back Pain and the Role of Physiotherapy in Bangladesh: A Qualitative Study
Bibliographic record
Abstract
BACKGROUND: Low back pain (LBP) is a leading global cause of disability, with the most significant burden now observed in low- and middle-income countries (LMICs). Despite the growing availability of physiotherapy, cultural perceptions and systemic factors may hinder its utilisation in Bangladesh. This study explores how patients with chronic LBP in Bangladesh perceive their condition and the role of physiotherapy. METHODS: Using interpretative phenomenological analysis, we conducted in-depth semi-structured interviews with 20 Bangladeshi adults (mean age 41.9 years) with chronic LBP (median duration 30 months). Participants were purposively sampled to capture diverse sociodemographic perspectives. Transcripts were thematically analysed to explore lived experiences with LBP and its management. RESULTS: Four interrelated themes emerged: (1) there was limited understanding of the causes of LBP; (2) physician authority strongly influenced perceptions of physiotherapy, reinforcing passive treatment approaches; (3) friends and family, social media, and the internet shaped expectations; and (4) cultural and spiritual beliefs promoted traditional remedies over evidence-based care. As a result of these perceptions, physiotherapy was often viewed as a last resort and was typically limited to passive modalities. CONCLUSION: Improving LBP care in Bangladesh may require culturally sensitive multilevel strategies, such as public education, upskilling of physiotherapists in active evidence-based interventions, and health policy reforms, to promote the availability of direct physiotherapy access. These strategies could help align patient expectations with contemporary care models and reduce LBP-related disability in LMICs.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".