Comparative Analysis of Traditional Versus Evidence Based Physiotherapy Approaches for Managing Chronic Low Back Pain

Abstract

Chronic low back pain is one of the leading causes of disability worldwide and imposes substantial socioeconomic burden. Physiotherapy remains a cornerstone in its management, yet variations exist between traditional physiotherapy approaches and evidence-based physiotherapy practices. Traditional approaches often emphasize passive modalities such as heat therapy, ultrasound, electrotherapy, and generalized exercise protocols, whereas evidence-based approaches integrate clinical expertise, patient values, and the best available research evidence, emphasizing active rehabilitation, cognitive behavioral strategies, graded exercise, and patient education. This study aims to comparatively analyze the effectiveness of traditional versus evidence-based physiotherapy approaches in managing chronic low back pain using a structural equation modeling approach through Smart PLS. A quantitative comparative design was conducted among 280 patients diagnosed with chronic low back pain attending rehabilitation centers. Pain intensity, functional disability, quality of life, and patient satisfaction were measured after twelve weeks of intervention. Smart PLS was employed to assess measurement reliability and to examine the structural relationship between treatment approach and clinical outcomes while controlling for age and duration of symptoms. Results revealed that evidence based physiotherapy demonstrated significantly stronger positive effects on pain reduction, functional improvement, and quality of life compared to traditional methods. The model explained 56 percent of the variance in treatment outcomes. The findings underscore the importance of integrating research evidence into physiotherapy practice to optimize patient centered outcomes. This study contributes to clinical decision making and policy development by providing empirical support for transitioning from passive modality centered care to active evidence driven rehabilitation strategies.