Traditional bone setting in Nigeria from the perspectives of patients and physiotherapists— clinical insights for low back pain management

Background: Traditional bone setting (TBS) remains a prevalent healthcare practice in Nigeria, offering complementary treatments for musculoskeletal conditions such as low back pain (LBP). This study explores the perspectives of both patients and physiotherapists regarding TBS and its implications for the management of LBP. Methods: A qualitative research approach was employed, utilizing semi-structured interviews with 25 participants (13 patients who had utilized TBS services for LBP, and 12 physiotherapists). Theoretical sampling was employed in participant recruitment until saturation. Recordings were transcribed and thematic analysis was conducted as a secondary analysis. Reporting was informed by the Consolidated Criteria for Reporting Qualitative Research (COREQ). Results: Eleven (11) participants were female and 14 were male; with a mean age of 35 years. Five themes were identified from this study: driving impetus for TBS, influencing perceptions with information, turning to TBS as a final recourse, exploring the primary alternative, and integrating TBS. The shift towards TBS for LBP stems from deficiencies in prevailing healthcare practices in Nigeria. Patients and physiotherapists hold varying perspectives regarding cultural significance, and effectiveness and safety of TBS compared to professional physiotherapy interventions. Accessibility, affordability, and perceived efficacy are common facilitators for the patronage of TBS among patients, while others were hesitant and viewed it as a last resort. Negative perception of physiotherapists about TBS for LBP were based on concerns regarding the lack of scientific evidence, standardized practices, and potential complications associated with the procedures. Conclusion: Participants consider TBS viable when professional physiotherapy fails, citing expectations for therapist-guided techniques, affordability, and cultural factors. Physiotherapists remain cautious, stressing the need for evidence-based care and noting severe TBS complications. Some participants advocate for integrating TBS with professional healthcare through collaboration and better communication. This study, supported by literature, highlights the potential for TBS integration, with open communication and training fostering collaboration. Future studies could investigate the practicality of this integration, prioritizing culturally appropriate, safe, and effective approaches to LBP management.