PERCEIVED ROLE OF PHYSIOTHERAPISTS IN THE MANAGEMENT OF LOW BACK PAIN AND PAIN MANAGEMENT STRATEGIES AMONG COMMERCIAL
MOTORCYCLE RIDERS IN MBAITOLI LGA, IMO STATE, NIGERIA
By
Desmond, Costoria
Email: desmondcostoria1@gmail.com Phone No: +234 808 877 6373
ABSTRACT
Commercial motorcycling is increasingly becoming a recognised occupational group, especially among the young people in Nigeria. The risk for Low Back Pain (LBP) is more envisaged in this occupational group, who are usually exposed to several musculoskeletal disorders that are usually being managed by physiotherapist but end up sorting for solutions in the wrong places, thus leading to a hike in significant quest for provision of accessible and affordable interventions for LBP. This study was designed to determine level of knowledge of physiotherapy and promote its utilization among motorcycle riders. The study was a descriptive cross-sectional study. A systematic random sampling technique was used to select the required study subjects. Quantitative data collection method was employed. Data analysis was done using SPSS version 20.0. Results showed that only 5% of the riders reported to have heard of physiotherapist and their roles, pain management strategies utilised by the respondents to manage their low back pain, 296(77.3%) reported to using drugs for their LBP such as Paracetamol 15.6%, while 44.2% of the respondent used drugs unknown to them. Majority of the respondents 306(79.9%) reported to have felt pain in the past. 19.5% reported that only stretching was their home management for their pain, majority 96.8% attested to not using their services, most 68.8% accepted to utilize it if the need arises. Majority of the respondents attested to the following risk factors of LBP to excessive exposure to cold weather, prolonged sitting on motorcycle, incorrect sleeping posture, prolonged sitting and standing, stress during and after work and heavy lifting of loads. The study suggests that only few commercial riders sought proper medical rehabilitation care for their low back pain. Majority chose over-thecounter medications while others went for other home management for pain such as stretching, use of ointments etc. Also, most of the riders lacked good knowledge of physiotherapy and their roles in pain management. Although, majority had never utilized their services, most accepted to utilize it if the need arises. Hence, the need for enlightenment programmes on the utilization of physical therapist with the use of physical rehabilitation to avoid or possibly reduce the risk of LBP.
Keywords: physiotherapists, low back pain, commercial motorcycle riders, Mbaitoli LGA.
1. Introduction
Low back pain (LBP) is one of the principal complaints by workers in the various occupations. It’s a major health problem affecting not only the workforce but also the general populace (Shirado, Kaneda & Strax, 2015). According to Shirado et al (2015), it’s prevalence is related to the type of occupations such as driving, riding, manual handling and occupations that involve a lot of improper body movements. It is a recognised societal problem from both a disablement and economic perspective, with costs exceeding that of coronary artery disease, respiratory infections, and diabetes (McKenzie & May, 2013). Low back pain is reported by McKenzie and May (2013) to have a lifetime prevalence of up to 75% and is one of the most common conditions for which individuals seek medical care. It is estimated that between 40% and 85% of people with LBP consults health care professionals about their pain (Carey, Evans, Hadler, Kalsbeek, McLaughlin & Fryer, 2015). It is frequently stated that a majority of LBP cases will resolve independent of intervention, but recent research study has shown that many cases progress to chronicity (Carey, et al., 2015). Occupation-related factors according to Vandergrift, Gold, Hanlon and Punnett (2012) are the most important risks associated with LBP. More than 80% of the population will experience an episode of LBP at some time during their lives (Freburger, Holmes & Agans, 2019). The modifiable risk factors for LBP include a sedentary lifestyle, obesity, tobacco smoking and drug dependence (Vindigni, Walker, Jamison, Da Costa, Parkinson & Blunden, 2015). Other modifiable factors are occupationrelated: poor posturing, prolonged sitting, twisting, bending, stooping and lifting of heavy loads. The Expert Group on the Global Burden of disease Study showed that LBP is among the top ten high burden diseases and injuries, with disability-adjusted life years (DALYs) higher than that of Human immunodeficiency syndrome (HIV), road injuries, tuberculosis, lung cancer, chronic obstructive pulmonary disease and preterm birth complications (Mohammad, 2013). There is a rising incidence of low back pain in the transportation sector of the economy (Wanamo, Abaya & Aschalew, 2017; Ismail, Hamed & Salwa, 2019).
Physical rehabilitation or physiotherapy is a healthcare profession concerned with the care of patients thereby improving the patient’s quality of life (QoL). It is defined as the healthcare profession with evidenced theoretical and clinical applications in providing care and treating individuals to improve, retain and restore their functionality and movements throughout their lifespan (World Confederation for Physical Therapy, 2022). They are seen in Health institutions (institutional hospitals, government hospitals), private practices, work place, sports sectors, educational institutions, rehabilitation centers etc (American Physical Therapy Association, 2018). Their services are needed in musculoskeletal, neurological, sports injuries, care in the intensive care units, Geriatrics among others. They apply wide range of physical therapies and techniques such as movement, ultrasound, heating, laser and other techniques in their several areas of specializations (International Labour Organization, 2014).
Knowledge is simply the general understanding about something and the familiarity with that. The knowledge and awareness of a profession can influence it either by promoting its misconception in cases of poor knowledge or by promoting its adequate appreciation and use in cases of good knowledge (Maruf, Ekediegwu, Akinpelu & Nwankwo, 2012). In other words, the recognition of a profession will certainly rely on knowledge, attitudes and perception of the public and even the profession’s stakeholders towards that profession (Dalley & Sim, 2017). Physiotherapy still faces great difficulty in acceptance and recognition, at least achieving a good status as an essential health care profession in most places in Nigeria. As stated, if the public are completely ignorant of the physiotherapy services it will result to poor acceptance of the physiotherapy roles as essential in health care system thereby resulting to therapy being sorted for from other healthcare providers or even non-healthcare providers as evident in patients with musculoskeletal problems sorting for care from traditional bonesetters (South African Society of Physiotherapy, 2019).
Commercial motorcycle riding is a fast evolving occupational group in Nigeria. The country alone has eight million registered commercial motorcyclists [8] thus constituting a major occupational group. It has always been a road safety concern as numerous crashes involving motorcycle riders are being recorded in our accident and emergency (A&E) departments and motorcycle riders are usually exposed to several musculoskeletal disorders that are usually being managed by physiotherapist but end up sorting for solutions in the wrong places, thus leading to a hike in significant quest for provision of accessible and affordable interventions for LBP.
Commercial motorcycling may be categorised as a high-risk job due to a variety of physical and psychological hazards associated with it (Ogundele, Afolabi, Fehintola, Olorunsola & Adelosoye, 2017). These hazards include inappropriate sitting posture, irregular helmet use, physical and psychological stress, failed road portions, poor compliance with road safety rules and overloading of motorcycles. Considering also that the original design of motorcycles was not with commercial intent, the risk for LBP might be more common than envisaged in this occupational group (Ogundele, et al, 2017). With the vast majority of communities in Nigeria and sub-Sahara Africa using it for commercial purposes because of the poor transport system and bad road network, there is a need to assess the health implication of such activity. Therefore, a good understanding of the current health care seeking behaviours will be vital in providing these interventions. Several studies have examined the knowledge, attitudes, perceptions of physiotherapy by health science students, medical practitioners, and even among aged residents of some selected areas; others also examined factors affecting the utilization of physiotherapy services among children with cerebral palsy etc., but no similar work has been done among commercial motorcycle riders considering the nature of their work (Priya & Anne, 2015; Anieto, Ativie, Okafor, Agono, Onah, Ogu Jency, Arasu & Navamani, 2021; Taj-Din, 2021; Bolarinde, Omoniyi & Joseph, 2021. Hence this study was aimed at determining the knowledge, utilization of physiotherapy services and management practices among commercial motorcycle riders in Mbaitoli Local Government Area of Imo State. It is very essential with the long-term objective of increasing the level of knowledge of physiotherapy and promote its utilization among commercial motorcycle riders.
Research Questions
Three research questions were formulated to guide the study:
- What is the knowledge of physiotherapy services among commercial motorcycle riders in Mbaitoli Local Government Area of Imo State?
- What is the pain management strategies utilized among commercial motorcycle riders in Mbaitoli Local Government Area of Imo State?
- What is the pain intensity among commercial motorcycle riders in Mbaitoli Local Government Area of Imo State?
- What are the perceived factors associated with risk of low back pain among commercial motorcycle riders in Mbaitoli Local Government Area of Imo State?
2. Material and methods
Research Design: The study adopted the cross-sectional survey research design. Crosssectional research design is an observational research that analyzes data of variables collected at one given point in time across a sample population.
Area of Study: The study was conducted in Mbaitoli LGA which is one of the local government area in Imo State. The local government area is made up of nine (9) autonomous communities namely, Mbieri, Orodo, Ogwa, Umunoha, Ubomiri, Ifakala, Afara, Ogbaku and Eziama-Obiato, Ngwa and Amanse. Mbaitoili LGA is one of the 27 local government areas in Imo state in the south-eastern part of Nigeria with Nwaorieubi as its head quarters. The LGA is strategically located as it shares common boundaries with four other Local Government Areas in Imo State. It is bordered by Awo-Omamma (Oru East), Umu-ofor/Akabo (Oguta LGA), Amazano/Umuaka (Njaba LGA), Afara and Umunoha (both in Mbaitoli LGA). It has four major villages namely: Umudim, Otolo, Uruagu and Nnewi-ichi. Mbaitoli is divided into 9 autonomous communities. The nine (9) autonomous communities includes: Mbieri, Orodo, Ogwa, Umunoha, Ubomiri, Ifakala, Afara, Ogbaku and Eziama-Obiato. The nine (9) autonomous communities includes: Mbieri, Orodo, Ogwa, Umunoha, Ubomiri, ,Ifakala, Afara, Ogbaku and Eziama-Obiato. It has a population of approximately 370,040 residents. The Mbaitoli people also engage in crafts such as basket making, broom making, hair weaving etc. The major places for conducting their economic activities are in the various market located at Mbaitoli Local Government Area and its environment. Mbaitoli Local Government Development Area has about 91 Primary schools, 26 Secondary Schools and 21 recognized Private Vocational Schools while administrative office of Federal School of Soil Science is located at Egbeada in the Area. Mbaitoli Local Government has fourteen health centres. Motorcycle is the dominant and most common means of transportation within the villages. Often motorcycles are used to ply within the vicinity or ply to other neighbouring villages and at least half of the people in this area has a motorcycle.
Population for the Study: The population for the study comprised 1494 registered members commercial motor riders, from the two units of the association in the LGA in all the nine autonomous communities in Mbaitoli LGA.
Sample for the Study: The sample for the study consisted of 420 motor cycle riders in Mbaitoli LGA. The sample was selected by the aid of Cohen, Manion, and Morrison (2011) standardized table for sample size that when a population is 5,000 or above at 95% confidence levels (5% intervals), the sample size should be 357 or above. A two stage sampling procedure was adopted to draw the sample size for the study. In the first stage, six out of the nine autonomous communities in Mbaitoli LGA were drawn using simple random sampling techniques of balloting without replacement. In the second stage purposive sampling technique was used to select 70 motor cycle riders who could give accurate information needed in the study from each of the six selected autonomous communities. This gave a total of 420 motor cycle riders selected for the study.
Instrument for Data Collection: Aresearcher-designed questionnaire was used for data collection. An interviewer-based semi-structured questionnaire was adapted according to the objectives of the study. The questionnaire had four (4) sections (sections I-IV). Section I was based on respondents’ socio-demographic profile; Section II was based on the respondents’ pain assessment using Oswestry Pain Assessment Scale; Section III was based on the respondents’ management of low back pain; and Section IV was based on the respondents’ knowledge and utilization of physiotherapy services. Three experts from the Department of Health Education, Alvan Ikoku Federal College of Education, Owerri validated the instrument. The experts’ suggestions were used in producing the final draft of the questionnaire. Test retest method was used to determine the reliability of the instrument. Twenty copies of the questionnaire were administered to motor cyclist who were not part of the population in Owerri-West LGA, a neighbouring town because they share the same characteristics. After two weeks, the same but fresh copies of the questionnaire were re-administered to the same respondents. The two results were correlated using Spearman Brown Order Correlation Coefficient formula. A reliable index of .75 was obtained and adjudged reliable for the study.
Method of Data Collection: Four hundred and twenty (420) copies of the questionnaire were administered to 420 commercial motor cyclists. Out of the 420 copies, 383 copies were completely filled and returned were used for data analysis.
Method of Data Analysis: Data that were generated from the copies of questionnaire distributed were analyzed using descriptive statistics of frequency counts and percentages to answer the research questions.
Ethical consideration
This study was approved by the Scientific and Ethics Review Boards of Alvan Ikoku Federal University of Education, Owerri. Informed consent was sought verbally from the riders before the questionnaires were administered. The recruitment script explained the purpose, significance and benefits of the study. The participants were assured of their responses’ confidentiality. Participants who couldn’t provide all the answers before picking up their passengers were regarded as invalid.
3. Results
Table 1: Demographic Characteristics of Respondents (N=383)
| S/N | Variable | Frequency | Percent (%) |
| 1 | Age 18 – 27 years | 130 | 33.9 |
| 28 – 37 years | 139 | 36.3 | |
| 38 – 47 years | 84 | 21.9 | |
| 48 years and above | 30 | 7.9 | |
| 2 | Level of Education Primary level | 197 | 51.4 |
| Secondary level | 140 | 36.6 | |
| Tertiary level 46 12.0 | |||
Data in Table 1 showed that 130(33.9%) of respondents are of the age group of 18-27 years, 139(36.3%) were of 28-37 years, 38 – 47 years were of 84(21.9%), while 48 years and above were of 30(7.9%). The table also showed that 197(51.4%) had primary educational level,
140(36.6%) had secondary educational level while 46(12.0%) had tertiary educational level.
Research question one
What is the knowledge of physiotherapy services among commercial motorcycle riders in Mbaitoli Local Government Area of Imo State? Data answering this research question are contained in table 2.
Table 2: Motorcycle riders’ Knowledge of physiotherapy services (n = 383)
| S/N | Knowledge of physiotherapy services | Knowledge Response f(%) |
| 1 | Heard of physiotherapist and their roles? | |
| Yes | 18(5.0) | |
| No | 365(95.0) | |
| 2 | What do they do? | |
| I don’t know what they do | 15(3.9) | |
| They do massage only | 15(3.9) | |
| They don’t have any role in human health | 7(1.8) | |
| 3 | Have you visited a physiotherapist? | |
| No | 376(98.2) | |
| Yes | 4(1.0) | |
| 4 | Reason for Visit | |
| Referred by a friend | 3(0.8) | |
| Had muscular injuries | 2(0.5) | |
| 5 | Frequency of the visit? | |
| Once | 2(0.5) | |
| Twice | 3(0.8) | |
| 6 | Venue of the visit? | |
| General hospital | 2(0.5) | |
| Physiotherapy clinic | 3(0.8) | |
| 7 | Experience during visit? | |
| Can’t say | 1(0.3) | |
| Very good | 2(0.5) | |
| 8 | Would you visit again? | |
| Yes | 2(0.5) | |
| No | 0(0.0) | |
| Can’t say | 1(0.3) | |
| 9 | Why not? | |
| Due to bad experience | 3(0.8) | |
| Due to the cost | 64(16.7) | |
| 10 | Would you advise your friend to visit a physiotherapist? | |
| Yes | 214(55.9) | |
| No | 46(12.0) | |
| Don’t know | 18(4.7) |
Result in Table 2 showed that overall, only 5% of the riders reported to have heard of physiotherapist and their roles. In responding to their idea of the roles of physiotherapist, 3.9% responded not to know what they do, 3.9% described their role as massage only and 1.8% stated that they do not have a role in human health. Out of the respondents, 1.0% have visited a physiotherapist while 98.2% have not. When those who have visited a physiotherapist were enquired on the reason(s) for the visit, 0.8% followed a friend to visit a physiotherapist, while 0.5% had skeletal injuries and muscular disorder; and the number of times of their visits were, once 0.5%, and twice 0.8%, respectively. Of all the respondents who had visited a physiotherapist, 0.5% visited a physiotherapy clinic, 0.8% visited the general hospital for physiotherapy services and only 0.5 reported their experience as good. Majority of the respondents 55.9% and 12.0% stated that they would visit a physiotherapist if asked to and would not advise their friend to visit a physiotherapist when the need arises respectively.
Research question two
What is the pain management strategies utilized among commercial motorcycle riders in Mbaitoli Local Government Area of Imo State? Data answering this research question are contained in table 3.
Table 3: Pain management strategies utilized among commercial motorcycle riders (n = 383).
| S/N | Items on Utilization of physiotherapy services | Responses f(%) |
| 1 | Do you use drugs when you have low back pain? | |
| Yes | 296(77.3) | |
| No | 36(9.4) | |
| No response | 11(2.9) | |
| 2 | Name of drugs used? | |
| Ibuprofen | 15(3.9) | |
| Paracetamol | 58(15.1) | |
| Aspirin | 2(0.5) | |
| Unknown | 117(30.5) | |
| 3 | Source of the drugs used? | |
| Over the counter | 98(25.6) | |
| Hospital | 6(1.6) | |
| Friend | 23(6.0) | |
| 4 | Do you use injections when you have low-back pain? | |
| Yes | 13(3.8) | |
| No | 84(21.9) | |
| No response | 12(3.3) | |
| 5 | Name of injection used? | |
| Unknown | 75(19.6) | |
| No response | 14(3.7) | |
| 6 | Source of the injection? | |
| Over the counter | 27(7.0) | |
| General hospital | 3(0.8) | |
| No response | 226(59.0) | |
| 7 | What home care management do you use when you have low-back pain? | |
| Massage | 13(3.4) | |
| Hot packs | 18(4.5) | |
| Use of oitments and skin creams | 15(3.9) | |
| Stretching and strengthening | 68(17.8) | |
| No response | 94(24.5) | |
| Others | 9(2.3) |
Table 3 above shows the pain management strategies utilised by the respondents to manage their low back pain, 296(77.3%) reported to using drugs for their LBP; and the commonly used drugs were ibuprofen (3.9%), paracetamol (15.1%), however huge number of the respondents do not know the drugs they used (30.5%). Majority (25.6%) sourced their drugs from over the counter. Only a few of the respondents (3.8%) use injectable, of which names they don’t know and got majorly from over the counter too. The respondents agreed to the use of home care management such as; stretching 17.8%, hot packs 4.5%, use of ointments and skin cream 3.9%, and massage 3.4%.
Research question three
What is the pain intensity among commercial motorcycle riders in Mbaitoli Local Government Area of Imo State? Data answering this research question are contained in table 4.
Table 4: Assessment of Pain Intensity using pain assessment scale among commercial motorcycle riders (n = 383)
| S/N | Items on Assessment of Pain Intensity using pain assessment scale | Responses f(%) |
| 1 | Have you ever felt pain in the last 12 months? | |
| Yes | 306(79.9) | |
| No | 77(20.1) | |
| 2 | Pain assessment scale for pain Intensity | |
| 0-20 | 258(67.4) | |
| 21-40 | 93(24.3) | |
| 41-60 | 32(8.4) | |
| 61-80 | 0(0.0) | |
| 81-100 | 0(0.0) |
Table 4 above shows the assessment of pain among the respondents using pain assessment scale. Majority of the respondents 306(79.9%) reported to have felt pain in the past. Using the pain assessment scale, majority 258(67.4%) reported their pain intensity to be within the range 0-20, followed by those 93(24.3%) that reported their pain intensity to be within 21-40 score while 32(8.4%) that reported their pain intensity to be within 41-60 score.
Research question four
What are the perceived factors associated with risk of low back pain among commercial motorcycle riders in Mbaitoli Local Government Area of Imo State? Data answering this research question are contained in table 5.
Table 5: Perceived factors associated with risk of low back pain (n = 383).
| S/N | Items on factors associated with risk of low back pain | Responses f(%) |
| 1 | Exposure to a very cold weather? | |
| Yes | 312(81.5) | |
| No | 24(6.3) | |
| No response | 46(12.0) | |
| 2 | Exposure to air condition /draft | |
| Yes | 253(66.1) | |
| No | 35(9.1) | |
| No response | 95(24.8) | |
| 3 | Motor vehicle accident? | |
| Yes | 274(71.5) | |
| No | 80(20.9) | |
| No response | 29(7.6) | |
| 4 | Sport injury | |
| Yes | 62(16.2) | |
| No | 181(47.3) | |
| No response | 140(36.6) | |
| 5 | Prolonged sitting on the motorcycle? | |
| Yes | 326(85.2) | |
| No | 23(6.0) | |
| No response | 34(8.9) | |
| 6 | Prolonged sitting and standing | |
| Yes | 309(80.7) | |
| No | 36(9.4) | |
| No response | 38(9.9) | |
| 7 | Incorrect body posture at home? | |
| Yes | 311(81.2) | |
| No | 45(11.7) | |
| No response | 27(7.0) | |
| 8 | Lifting/moving heavy loads? | |
| Yes | 289(75.5) | |
| No | 73(19.1) | |
| No response | 21(5.5) | |
| 9 | Stress during and after work? | |
| Yes | 267(69.7) | |
| No | 52(13.4) | |
| No response | 64(16.7) | |
| 10 | Incorrect sleeping position? | |
| Yes | 343(89.6) | |
| No | 28(7.3) | |
| No response | 12(3.1) | |
| 11 | Domestic activities | |
| Yes | 288(75.2) | |
| No | 43(11.2) | |
| No response | 52(13.6) |
Result in Table 5 showed that exposures to some factors were related to low back pain, 81.5% riders reported excessive exposure to cold weather, 85.2% reported prolonged sitting on motorcycle while 89.6% reported incorrect sleeping posture. Moreso, 80.7% reported prolonged sitting and standing, 69.7% attested stress during and after work while 75.5% attested heavy lifting of loads.
4. Discussion
Study finding show that the motorcycle riders’ view of physiotherapy and their roles in pain management is scare. This study shows some variables in the respondents’ view of physiotherapy and their roles in pain management. Only 55% of the riders reported to have heard of physiotherapist and their roles. In responding to their idea of the roles of physiotherapist, 3.9% responded not to know what they do, 3.9% described their role as massage only and 1.8% stated that they do not have a role in human health. Out of the respondents, 1.0% have visited a physiotherapist while 98.2% have not. When those who have visited a physiotherapist were enquired on the reason(s) for the visit, 0.8% followed a friend to visit a physiotherapist, while 0.5% had skeletal injuries and muscular disorder; and the number of times of their visits were, once 0.5%, and twice 0.8%, respectively. Of all the respondents who had visited a physiotherapist, 0.5% visited a physiotherapy clinic, 0.8% visited the general hospital for physiotherapy services and only 0.5 reported their experience as good. Majority of the respondents 55.9% and 12.0% stated that they would visit a physiotherapist if asked to and would not advise their friend to visit a physiotherapist when the need arises respectively. This could be as a result of their belief in doing what is right and following instructions.
This study revealed that the most common pain management strategy used by 50% of the respondents attested to their low back pain was pain-relief drugs such as Paracetamol (15.1%), Ibuprofen (3.9%), while 30.5% of the respondents used drugs unknown to them. Although this study is not focused to estimate the level of education of commercial riders, an average percentage (36.6%) attained secondary level of education but only 2.6% of the rider’s preferred herbal medicine. However, this is not in agreement with the findings of Olorufemi et al. (2017), where a high proportion of motorcyclists (51.4%) attained a primary level of education and thus a lack of education might explain their poor health seeking behaviour and preference for herbal medicine. A higher percentage of the respondent 25.6% got their drugs from over the counter while 3.8% and 3.8% of the respondents got theirs from a friend and hospital respectively. This may be linked to their financial status and accessibility of these over-thecounter drugs. 84.4% of the respondents reported not using injectable when they have low back pain while 7.8% affirmed to using injectable but could not identify the names of the medication. This is probably because of where they got them; 6.5% of the respondent got the injectable from over the counter while 1.3% of the respondent got theirs from the hospital. This shows that only a few respondents sought proper medical attention in managing their pain. This agrees with the findings of Haetzman et al (2013) and Akinpelu et al, (2017) reported that nonprescription medication were been taken by a high number of individuals with chronic pain, 113 (73.3%) respondents agreed to the use of home care management such as; stretching 19.5%, hot packs 5.8%, use of ointments and skin cream 7.8%, and massage 5.8%. Some respondent also uses two or more combination of the home remedy such as stretching, hot packs, use of ointment and massage 3.9%, use of ointment and massage 4.5%, stretching (17.8%) and hot packs 4.5%.
5. Conclusion
Although Physiotherapy has a massive growth in evidence based, its scope of practices through research and genuine demand in services, it still faces great difficulty in acceptance and recognition and at least achieving a good status as an essential health care profession in Nigeria.
This can never get better if the public are completely ignorant of their services (American Physical Therapy Association, 2018). Our study suggests that only few commercial riders sought proper medical care for their low back pain. Majority chose over-the-counter medications while others went for other home management strategies for pain such as stretching, use of ointments etc. Also, most of the riders lack a good knowledge of physiotherapy and their roles in pain management. Although, majority had never utilized their services, most accepted to utilize it if the need arises. It can be concluded that providing education to the riders may enhance their knowledge regarding the relationship between physiotherapy and pain management.
There is therefore an urgent need to improve education regarding physiotherapy and rehabilitation services for all riders and other populations. Physiotherapists need to be proactive in this area and need the support of health service and training institutions and government.
Recommendation
It is recommended that the professional body of physiotherapy organize programs aimed at improving the knowledge of motorcycle riders about the practice of physiotherapy, treatment and modalities. Physiotherapy professionals should also use the mass media to create more awareness among the general public. There is need for Physiotherapists in this population to offer more voluntary services to communities in an effort to educate and create awareness.
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