The Role of Physiotherapists in Promoting Health for Patients with Chronic Low Back Pain in the Community: A Literature Review and Guidelines Presentation

Main Article Content

Jirawat Tiwawatpakorn
Bhunyabhadh Chaimay
Somkiattiyos Woradet
Sunisa Rani

Abstract

This article overviews the crucial role of physical therapists in health promotion for individuals with chronic low back pain (CLBP) in community settings. It emphasizes CLBP as a complex biopsychosocial condition, not merely a physical ailment. Physical therapists are therefore ideally positioned as key personnel within primary healthcare to effectively implement health promotion principles in communities. Their essential roles include holistic assessment, education and awareness-raising, designing accessible and context-appropriate exercise programs, fostering self-management skills, coordinating with community stakeholders, and leveraging technology to enhance service accessibility. Although implementation faces several challenges, such as shortages in personnel, resources, and funding, as well as policy limitations and community attitudes, this article proposes concrete policy recommendations, curriculum development, practical guidelines for physical therapists in community work, and areas for further research to overcome these barriers. Therefore, supporting the role of physical therapists in communities will contribute to improving the quality of life for CLBP patients and fostering sustainable well-being within society.

Article Details

How to Cite
1.
Tiwawatpakorn J, Chaimay B, Woradet S, Rani S. The Role of Physiotherapists in Promoting Health for Patients with Chronic Low Back Pain in the Community: A Literature Review and Guidelines Presentation. Thai J Phys Ther [internet]. 2026 Apr. 22 [cited 2026 Sep. 20];48(1):25-37. available from: https://he02.tci-thaijo.org/index.php/tjpt/article/view/278902
Section
Review Article

References

Bardin LD, King P, Maher CG. Diagnostic triage for low back pain: a practical approach for primary care. Med J Aust . 2017;206(6):268–73.

Chiarotto A, Koes BW. Nonspecific Low Back Pain. N Engl J Med. 2022;(18):1733–40.

Kreiner DS, Matz P, Bono CM, Cho CH, Easa JE, Ghiselli G, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain. Spine J. 2020;20(7):998–1024.

He C, Chen H, Guo L, Xu L, Liu Q, Zhang J, et al. Prevalence and factors associated with comorbid depressive symptoms among people with low back pain in China: A cross-sectional study. Front Psychiatry. 2022;13:1–9.

SV, S. K. Central Sensitization in Chronic Pain Conditions: Mechanisms, Clinical Implications, and Treatment Strategies. Preprints 2025, 2025031506.

Yamada AS, Simon D, Antunes FTT, Say KG, Souza AH d. Psychosocial factors associated with disability in patients with non-specific chronic low back pain: A cross-sectional study. Rehabilitation. 2023;57(2):100750.

Chen S, Chen M, Wu X, Lin S, Tao C, Cao H, et al. Global, regional and national burden of low back pain 1990–2019: A systematic analysis of the Global Burden of Disease study 2019. J Orthop Transl. 2022;32:49–58.

Fatoye F, Gebrye T, Ryan CG, Useh U, Mbada C. Global and regional estimates of clinical and economic burden of low back pain in high-income countries: a systematic review and meta-analysis. Front Public Health. 2023;11:1–10.

Petre B, Torbey S, Griffith JW, De Oliveira G, Herrmann K, Mansour A, et al. Smoking increases risk of pain chronification through shared corticostriatal circuitry. Hum Brain Mapp. 2015;36(2):683–94.

Tiwawatpakorn J, Sutheeravat P, Wongkiratimethawi T. Rehabilitation Management in the Community of Patients with Non-Specific Low Back Pain. South Coll Netw J Nurs Public Health. 2023;10(2):1–13.

Park HJ, Choi JY, Lee WM, Park SM. Prevalence of chronic low back pain and its associated factors in the general population of South Korea: a cross-sectional study using the National Health and Nutrition Examination Surveys. J Orthop Surg. 2023;18(1):29.

Udom C, Janwantanakul P, Kanlayanaphotporn R. The prevalence of low back pain and its associated factors in Thai rubber farmers. J Occup Health. 2016;58(6):534–42.

Ho-A-Tham N, Ting-A-Kee B, Struyf N, Vanlandewijck Y, Dankaerts W. Low back pain prevalence, beliefs and treatment-seeking behaviour in multi-ethnic Suriname. Rheumatol Adv Pract. 2021;5(3):1–10.

Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 2018;391(10137):2368–83.

Ge L, Pereira MJ, Yap CW, Heng BH. Chronic low back pain and its impact on physical function, mental health, and health-related quality of life: a cross-sectional study in Singapore. Sci Rep. 2022;12(1):20040.

Negash NA, Tadele A, Jember Ferede A. Prevalence and associated factors of low back pain among healthcare professionals at University of Gondar Comprehensive and Specialized Hospital, Northwest Ethiopia: Cross-Sectional Study. J Pain Res. 2022;15: 1543–52.

Hotta GH, Oliveira AS de, Alaiti RK, Reis FJJ dos. Therapeutic approach to pain-related fear and avoidance in adults with chronic musculoskeletal pain: an integrative review and a roadmap for clinicians. BrJP. 2022;5:72–9.

Gibbs D, McGahan BG, Ropper AE, Xu DS. Back Pain: differential diagnosis and management. Neurol Clin. 2023;41(1):61–76.

Hayden JA, Ellis J, Ogilvie R, Malmivaara A, Tulder MW van. Exercise therapy for chronic low back pain (Review) [Internet]. 9th ed. USA: John Wiley & Sons, Ltd.; 2021. 553 p.

Khutok K, Janwantanakul P, Jensen MP, Kanlayanaphotporn R. Responsiveness of the PROMIS-29 Scales in Individuals with chronic low back pain. Spine. 2021;46(2):107–13.

Ma X, Chen R, Li W, Huang P. A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: short-term outcomes of pain and disability. Physiother Theory Pract. 2024;40(9):2130–49.

Ferreira ML, Luca K de, Haile LM, Steinmetz JD, Culbreth GT, Cross M, et al. 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. Lancet Rheumatol. 2023;5(6):e316–29.

Eitivipart AC, Arora M, Quel de Oliveira C, Heard R, Middleton JW, Davis GM. Assessing physical activity and health-related quality of life in individuals with spinal cord injury: a national survey in Thailand. Disabil Rehabil. 2022; 44(23):7048–58.

Sakulsriprasert P, Vachalathiti R, Kingcha P. Association among pain, disability, and functional capacity in patients with chronic non-specific low back pain: A cross-sectional study. J Back Musculoskelet Rehabil. 2021;34(1):149–57.

Chokprasit P, Yimthiang S, Veerasakul S. Predictors of low back pain risk among rubber harvesters. Int J Environ Res Public Health. 2022;19(17):10492.

Alaiti RK, Reis FJJ, Arruda-Sanchez T, Caneiro J, Meulders A. Unraveling the role of fear and avoidance behavior in chronic musculoskeletal pain: from theory to physical therapy clinical practice. Braz J Phys Ther. 2025;29(3):101197.

Thiese MS, Lu ML, Merryweather A, Tang R, Ferguson SA, Malloy EJ, et al. Psychosocial Factors and Low Back Pain Outcomes in a Pooled Analysis of Low Back Pain Studies. J Occup Environ Med. 2020;62(10):810.

O’Sullivan P, Caneiro JP, O’Keeffe M, O’Sullivan K. Unraveling the complexity of low back pain. J Orthop Sports Phys Ther. 2016;46(11):932–7.

Jones KC, Tocco EC, Marshall AN, McLeod TCV, Bacon CEW. Pain education with therapeutic exercise in chronic nonspecific low back pain rehabilitation: a critically appraised topic. J Sport Rehabil. 2020;29(8):1204–9.

Dawes DE. The Political Determinants of Health. 1st ed. Baltimore, Maryland, USA: Johns Hopkins University Press; 2020. 241 p.

Sotiropoulos S, Papandreou M, Mavrogenis A, Tsaroucha A, Georgoudis G. The Effects of Qigong and Tai Chi Exercises on Chronic Low Back Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cureus. 2025;3(2):1–15.

Magnusson DM, Rethorn ZD, Bradford EH, Maxwell J, Ingman MS, Davenport TE, et al. Population Health, Prevention, Health Promotion, and Wellness Competencies in Physical Therapist Professional Education: Results of a Modified Delphi Study. Phys Ther. 2020;100(9):1645–58.

Mokwena K, Phetlhe K. Assessment of health promotion content in undergraduate physiotherapy curricula. South Afr J Physiother. 2015;71(1):242.

Tiwawatpakorn J, Sutheeravat P, Wongkiratimethawi T, Sukubol S, Duangjan Y. Rehabilitation model for patients with chronic lower back pain in the community using innovative care for a chronic conditions framework. J Med Health Sci. 2021;28(3):42–60.