Daniyal Ahmed*

Department of Public Health, Health Services Academy, Pakistan

*Corresponding Author: Daniyal Ahmed, Department of Public Health, Health Services Academy, Pakistan.

Received: January 23, 2026; Published: February 13, 2026

Objective: To compare the effectiveness of combined physiotherapy and medical treatment versus medical treatment alone in reducing the severity of backache.

Methodology: A quasi-experimental study was conducted in the Surgery Outpatient Department of Al-Nafees Medical College and Hospital, Islamabad, during 2018. A total of 457 patients aged 18 - 65 years with non-specific backache of more than four weeks’ duration were included through purposive sampling. Participants were allocated into two groups: Group A (n = 229) received physiotherapy plus medical treatment, and Group B (n = 228) received medical treatment only. Pain severity was graded on a four-point scale (none, mild, moderate, severe) before and after treatment. Data were analysed using SPSS version 26.0, with Chi-square and Wilcoxon signed-rank tests applied; a p-value < 0.05 was considered statistically significant.

Results: A total of 457 patients (140 males, 317 females) were enrolled and divided into two groups: Group A (n = 229) received combined physiotherapy and medical treatment, while group B (n = 228) received medical treatment only. Both groups showed significant post-treatment improvement in pain severity (p < 0.001, Wilcoxon signed-rank test). The mean reduction in severity score was greater in group A (2.45 ± 0.64) than in group B (2.28 ± 0.71; t = 2.12, p = 0.035). The overall improvement rate was 70.3% in group A and 68.0% in group B. Female participants exhibited slightly greater proportional improvement than males. These findings indicate that adding physiotherapy to standard medical management provides superior pain relief and functional recovery in patients with backache.

Conclusion: Both treatment modalities were effective in alleviating backache; however, combined physiotherapy and medical therapy achieved greater pain reduction and functional improvement. The addition of physiotherapy significantly enhanced recovery, particularly among female patients, supporting its role as a valuable adjunct to standard medical management of backache.

References

1. Mohamed S. “Low back pain: A comprehensive review on the diagnosis, treatment options, and the role of other contributing factors”. Open Access Macedonian Journal of Medical Sciences 9F (2021): 347-359.
2. Chou R., et al. “Pain management injection therapies for low back pain” (2015).
3. Javed S., et al. “Prevalence of low back pain among medical doctors of the teaching hospitals in Karachi, Pakistan: A cross-sectional survey”. SAGE Open Medicine 11 (2023): 20503121231157217.
4. Pérez-Piñero S., et al. “Dietary supplementation with plant extracts for amelioration of persistent myofascial discomfort in the cervical and back regions: a randomized double-blind controlled study”. Frontiers in Nutrition 11 (2024): 1403108.
5. Baig AA., et al. “Association of demographics, lumbar active range of motion and disability in chronic low back: a baseline data analysis of a randomized controlled trial from Pakistan”. BMC Musculoskeletal Disorders1 (2024): 489.
6. Hassan N., et al. “Manual therapy followed by dynamic strengthening exercise along with conventional physiotherapy versus manual therapy along with conventional physiotherapy on the improvement of pain and functional disability in patients with chronic non-specific low back pain: a randomized-controlled pilot study”. Journal of Spine Research and Surgery3 (2022): 104-110.
7. Rahman MA., et al. “Assessing pain severity and treatment outcomes in patients with low back pain: A Structural equation modeling approach at the center for the rehabilitation of the Paralysed, Bangladesh”. PLoS ONE5 (2024): e0303939.
8. Ahmed D., et al. “Prevalence of backache patients presented to surgery OPD at Al-Nafees Medical College and hospital”. Acta Scientific Clinical Case Reports10 (2020): 03-07.
9. Kim JH. “Comparative analysis of machine learning models for efficient low back pain prediction using demographic and lifestyle factors”. Journal of Back and Musculoskeletal Rehabilitation6 (2024): 1631-1640.
10. Li Y., et al. “Global burden of low back pain and its attributable risk factors from 1990 to 2021: a comprehensive analysis from the global burden of disease study 2021”. Frontiers in Public Health 12 (2024): 1480779.
11. Chen D., et al. “A causal examination of the correlation between hormonal and reproductive factors and low back pain”. Frontiers in Endocrinology 15 (2024): 1326761.
12. Güngör E and Karakuzu Güngör Z. “Obstetric-related lower back pain: the effect of number of pregnancy on development of chronic lower back pain, worsening of lumbar disc degeneration and alteration of lumbar sagittal balance”. Journal of Orthopaedic Surgery and Research1 (2024): 174.
13. Popajewski M., et al. “Maternal parity effect on spine posture changes and back pain during pregnancy”. Healthcare22 (2024): 2202.
14. Farley T., et al. “Chronic low back pain: History, symptoms, pain mechanisms, and treatment”. Life7 (2024): 812.
15. Oertel J., et al. “Acute low back pain: Epidemiology, etiology, and prevention: WFNS spine committee recommendations”. World Neurosurgery: X 22 (2024): 100313.
16. Hansen LA., et al. “Differences in demographics and clinical outcomes in older, middle-aged, and younger adults with low back pain receiving chiropractic care”. Chiropractic and Manual Therapies1 (2025): 31.
17. Paul VC., et al. “Association of smartphone addiction with pain, sleep, anxiety, and depression in university students”. Fisioterapia em Movimento 36 (2023): e36110.
18. Aabdelkader B., et al. “Implementation of an adapted physical activity therapy protocol for patients with low back pain”. Gymnasium: Scientific Journal of Education, Sports and Health1 (2021): 83-96.
19. Ali M., et al. “Combined effect of vitamin D supplementation and physiotherapy on reducing pain among adult patients with musculoskeletal disorders: a quasi-experimental clinical trial”. Frontiers in Nutrition 8 (2021): 717473.
20. Kossakowska K., et al. “Factors of subjective assessment of the effectiveness of physiotherapy: a study on patients with degenerative disease of the spine”. Family Medicine and Primary Care Review2 (2018): 131-138.
21. Ghafoor I., et al. “Effectiveness of NSAIDs and physiotherapy in acute low back pain on pain and function in workers of Pakistan textile industry”. Journal of Liaquat University of Medical and Health Sciences4 (2019): 320-324.
22. Hayden JA., et al. “Exercise therapy for chronic low back pain: protocol for an individual participant data meta-analysis”. Systematic Reviews1 (2012): 64.
23. Global CG. “Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021”. The Lancet Rheumatology6 (2023): e316-e329.
24. Şahin N., et al. “Effectiveness of physical therapy and exercise on pain and functional status in patients with chronic low back pain: a randomized-controlled trial”. Turkish Journal of Physical Medicine and Rehabilitation1 (2017): 52.
25. Farley T., et al. “Chronic low back pain: History, symptoms, pain mechanisms, and treatment”. Life 7 (2024): 812.
26. Tikhile P., et al. “Unveiling the efficacy of physiotherapy strategies in alleviating low back pain: a comprehensive review of interventions and outcomes”. Cureus3 (2024): e56013.
27. Baroncini A., et al. “Physiotherapeutic and non-conventional approaches in patients with chronic low-back pain: a level I Bayesian network meta-analysis”. Scientific Reports1 (2024): 11546.
28. Akhtar MW., et al. “Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial”. Pakistan Journal of Medical Sciences4 (2017): 1002-1006.
29. Alqhtani RS., et al. “Efficacy of core-strengthening and intensive dynamic back exercises on pain, core muscle endurance, and functional disability in patients with chronic non-specific low back pain: A randomized comparative study”. Journal of Clinical Medicine2 (2024): 475.
30. Badar S., et al. “Attributes of low back pain among physical therapists and nurses in Pakistan: Low back pain among physical therapists and nurses”. Pakistan Journal of Health Sciences 29 (2024): 02-07.
31. Hartvigsen J., et al. “What low back pain is and why we need to pay attention”. The Lancet10137 (2018): 2356-2367.

Citation

Citation: Daniyal Ahmed. “Physiotherapy as an Adjunct to Medical Therapy in Backache: Comparative Effectiveness Analysis". Acta Scientific Medical Sciences 10.2 (2026): 100-109.

Copyright

Copyright: © 2026 Daniyal Ahmed. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.