Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Advertisement

Scientific Reports
  • View all journals
  • Search
  • My Account Login
  • Content Explore content
  • About the journal
  • Publish with us
  • Sign up for alerts
  • RSS feed
  1. nature
  2. scientific reports
  3. articles
  4. article
Utilization patterns and perceived effectiveness of manual therapy for low back pain among Saudi physical therapists: a national cross-sectional study
Download PDF
Download PDF
  • Article
  • Open access
  • Published: 12 February 2026

Utilization patterns and perceived effectiveness of manual therapy for low back pain among Saudi physical therapists: a national cross-sectional study

  • Yahya M. Zubayni1,
  • Saad A. Alhammad2,
  • Faris A. Alodaibi2,
  • Abdulfattah S. Alqahtani2,
  • Amir Iqbal  ORCID: orcid.org/0000-0002-9080-367X1 &
  • …
  • Ahmad H. Alghadir1 

Scientific Reports , Article number:  (2026) Cite this article

  • 101 Accesses

  • Metrics details

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Health care
  • Health occupations
  • Medical research

Abstract

Low back pain (LBP) is a leading cause of disability worldwide, and manual therapy (MT) is commonly used in its management. However, utilization patterns and perceived effectiveness vary according to training and clinical context, with limited national-level evidence describing how Saudi physical therapists apply MT in routine LBP care. To examine national patterns of MT utilization for LBP among licensed Saudi physical therapists, to identify commonly applied techniques, and to evaluate professional and educational factors associated with perceived effectiveness and frequency of use. A cross-sectional survey was conducted from January to March 2025 using a structured online questionnaire distributed nationwide via professional and social-media platforms. Eligible participants were Saudi Commission for Health Specialties (SCFHS)–licensed physical therapists actively managing LBP. The questionnaire assessed demographics, MT training exposure, frequency and type of MT use, perceived effectiveness, and outcome-measurement practices. Content validity was confirmed by six experts (S-CVI/Avg = 0.96). Data were analyzed using descriptive statistics, chi-square tests, Spearman’s rho correlation, and multivariable ordinal logistic regression (SPSS v28; α < 0.05). Of 182 responses received, 173 met the inclusion criteria. Most participants reported using MT for LBP management, with 89% employing it at least occasionally and 20% reporting routine use. MT was rated as important or very important by 87.9% of respondents, and more than half assigned a perceived usefulness score ≥ 6/10. Greater exposure to MT training was independently associated with higher MT utilization and stronger perceived effectiveness (p < 0.001; Nagelkerke R² = 0.47), whereas years of experience and clinical specialization were not significantly associated. MT is widely used and positively perceived by Saudi physical therapists managing LBP. Variability in its utilization and perceived effectiveness appears primarily related to differences in training exposure. These findings describe current practice patterns and professional perceptions and may inform future educational planning, without inferring clinical effectiveness.

Similar content being viewed by others

Clinical relevance of combined treatment with exercise in patients with chronic low back pain: a randomized controlled trial

Article Open access 24 July 2024

Physiotherapeutic and non-conventional approaches in patients with chronic low-back pain: a level I Bayesian network meta-analysis

Article Open access 21 May 2024

Utilizing machine learning to analyze trunk movement patterns in women with postpartum low back pain

Article Open access 12 August 2024

Data availability

The dataset supporting the findings of this study has been deposited in the Open Science Framework (OSF) repository and is openly available at https://osf.io/p2s69/overview? view_only=99d6801264334cd896e30278631f3093 under the title “MT Utilization and Perceived Effectiveness Dataset.”

Abbreviations

LBP:

Low back pain

MT:

Manual Therapy

SCFHS:

Saudi Commission for Health Specialties

CPD:

Continuing-professional-development

IFOMPT:

International Federation of Orthopaedic Manipulative Physical Therapists

S-CVI:

Scale-Level Content Validity Index

VAS:

Visual Analog Scale

NPRS:

Numeric Pain Rating Scale

RMDQ:

Roland–Morris Disability Questionnaire

QBPDS:

Quebec Back-Pain Disability Scale

SF-12/SF-36:

Short Form Health Survey

SPSS:

Statistical Package for the Social Sciences

CHERRIES:

Checklist for Reporting Results of Internet E-Surveys

STROBE:

Strengthening the Reporting of Observational Studies in Epidemiology

OSF:

Open Science Framework

References

  1. Vos, T. et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet 396 (10258), 1204–1222. https://doi.org/10.1016/S0140-6736(20)30925-9 (2020).

    Google Scholar 

  2. Ferreira, M. L. 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. 5 (6), e316–e329. https://doi.org/10.1016/S2665-9913(23)00098-X (2023).

    Google Scholar 

  3. Hoy, D., Brooks, P., Blyth, F. & Buchbinder, R. The epidemiology of low back pain. Best Pract. Res. Clin. Rheumatol. 24 (6), 769–781. https://doi.org/10.1016/j.berh.2010.10.002 (2010).

    Google Scholar 

  4. Hartvigsen, J. et al. What low back pain is and why we need to pay attention. Lancet 391 (10137), 2356–2367. https://doi.org/10.1016/S0140-6736(18)30480-X (2018).

    Google Scholar 

  5. Yang, Y. et al. Focus on the impact of social factors and lifestyle on the disease burden of low back pain: findings from the global burden of disease study 2019. BMC Musculoskelet. Disord. 24 (1), 679 (2023).

    Google Scholar 

  6. Al Amer, H. S. Low back pain prevalence and risk factors among health workers in Saudi Arabia: a systematic review and meta-analysis. J. Occup. Health 62(1), e12155. https://doi.org/10.1002/1348-9585.12155 (2020).

    Google Scholar 

  7. Aldera, M. A., Alexander, C. M. & McGregor, A. H. Prevalence and incidence of low back pain in the Kingdom of Saudi Arabia: a systematic review. J. Epidemiol. Glob Health 10(4), 269–279. https://doi.org/10.2991/jegh.k.200417.001 (2020).

    Google Scholar 

  8. George, S. Z. et al. Interventions for the management of acute and chronic low back pain: revision 2021. J. Orthop. Sports Phys. Ther. 51 (11), CPG1–CPG60. https://doi.org/10.2519/jospt.2021.0304 (2021).

    Google Scholar 

  9. Qaseem, A., Wilt, T. J., McLean, R. M. & Forciea, M. A. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American college of physicians. Ann. Intern. Med. 166 (7), 514–530. https://doi.org/10.7326/M16-2367 (2017).

    Google Scholar 

  10. Delitto, A. et al. Low back pain. J. Orthop. Sports Phys. Ther. 42 (4), A1–A57. https://doi.org/10.2519/jospt.2012.42.4.A1 (2012).

    Google Scholar 

  11. Oliveira, C. B. et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur. Spine J. 27 (11), 2791–2803. https://doi.org/10.1007/s00586-018-5673-2 (2018).

    Google Scholar 

  12. Nicol, V. et al. Chronic low back pain: a narrative review of recent international guidelines for diagnosis and conservative treatment. J. Clin. Med. 12(4), 1685. https://doi.org/10.3390/jcm12041685 (2023).

    Google Scholar 

  13. Zhou, T., Salman, D. & McGregor, A. H. Recent clinical practice guidelines for the management of low back pain: a global comparison. BMC Musculoskelet. Disord. 25 (1), 344. https://doi.org/10.1186/s12891-024-07468-0 (2024).

    Google Scholar 

  14. Bronfort, G., Haas, M., Evans, R., Leininger, B. & Triano, J. Effectiveness of manual therapies: the UK evidence report. Chiropr. Osteopat. 18, 3. https://doi.org/10.1186/1746-1340-18-3 (2010).

    Google Scholar 

  15. Chitale, N., Patil, D. S., Phansopkar, P. & Joshi, A. A review on treatment approaches for chronic low back pain via mulligan’s movement with mobilization and physical therapy. Cureus 14 (8), e28127. https://doi.org/10.7759/cureus.28127 (2022).

    Google Scholar 

  16. Cankaya, M. S. & Pala, O. O. Outcomes of Mulligan concept applications in obese individuals with chronic mechanical low back pain: a randomized controlled trial. Life (Basel). 14 (6), 754. https://doi.org/10.3390/life14060754 (2024).

    Google Scholar 

  17. Cyriax, J. Textbook of Orthopaedic Medicine 11th edn (Baillière Tindall, 1984).

  18. Neto, T. et al. Effects of lower body quadrant neural mobilization in healthy and low back pain populations: a systematic review and meta-analysis. Musculoskelet. Sci. Pract. 27, 14–22. https://doi.org/10.1016/j.msksp.2016.11.014 (2017).

    Google Scholar 

  19. Bailly, F. et al. Clinical guidelines and care pathway for management of low back pain with or without radicular pain. Jt. Bone Spine 88(6), 105227. https://doi.org/10.1016/j.jbspin.2021.105227 (2021).

    Google Scholar 

  20. Shipton, E. A. Physical therapy approaches in the treatment of low back pain. Pain Ther. 7 (2), 127–137. https://doi.org/10.1007/s40122-018-0105-x (2018).

    Google Scholar 

  21. Ladeira, C. E., Cheng, M. S. & Hill, C. J. Physical therapists’ treatment choices for non-specific low back pain in florida: an electronic survey. J. Man. Manip Ther. 23 (2), 109–118. https://doi.org/10.1179/2042618613Y.0000000065 (2015).

    Google Scholar 

  22. Foster, N. E., Thompson, K. A., Baxter, G. D. & Allen, J. M. Management of non-specific low back pain by physiotherapists in Britain and Ireland. Spine 24 (13), 1332–1342. https://doi.org/10.1097/00007632-199907010-00011 (1999).

    Google Scholar 

  23. Kuik, M., Calley, D., Buus, R. & Hollman, J. Beliefs and practice patterns of spinal thrust manipulation for mechanical low back pain of physical therapists in Minnesota. J. Man. Manip Ther. 32 (4), 421–428. https://doi.org/10.1080/10669817.2023.2279821 (2024).

    Google Scholar 

  24. Alghadir, A. H., Iqbal, Z. A. & Iqbal, A. Knowledge and utilization of manual therapy in the management of knee osteoarthritis by physical therapists in Saudi arabia: a cross-sectional study. BMC Public. Health. 24 (1), 3379. https://doi.org/10.1186/s12889-024-20923-w (2024).

    Google Scholar 

  25. Fairbank, J. C. T. & Pynsent, P. B. The Oswestry disability index. Spine 25 (22), 2940–2953. https://doi.org/10.1097/00007632-200011150-00017 (2000).

    Google Scholar 

  26. Roland, M. & Fairbank, J. The Roland–Morris disability questionnaire and the Oswestry disability questionnaire. Spine 25 (24), 3115–3124. https://doi.org/10.1097/00007632-200012150-00006 (2000).

    Google Scholar 

  27. Roland, M. & Morris, R. A study of the natural history of back pain. Spine 8 (2), 141–144. https://doi.org/10.1097/00007632-198303000-00004 (1983).

    Google Scholar 

  28. Kopec, J. A. et al. The Quebec back pain disability scale. Spine 20 (3), 341–352. https://doi.org/10.1097/00007632-199502000-00016 (1995).

    Google Scholar 

  29. Jenkinson, C. & Layte, R. Development and testing of the UK SF-12. J. Health Serv. Res. Policy. 2 (1), 14–18. https://doi.org/10.1177/135581969700200105 (1997).

    Google Scholar 

  30. Ware, J. E. SF-36 health survey update. Spine 25 (24), 3130–3139. https://doi.org/10.1097/00007632-200012150-00008 (2000).

    Google Scholar 

  31. Waddell, G., Newton, M., Henderson, I., Somerville, D. & Main, C. J. A Fear-Avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 52 (2), 157–168. https://doi.org/10.1016/0304-3959(93)90127-B (1993).

    Google Scholar 

  32. Snaith, R. P. & Zigmond, A. S. The hospital anxiety and depression scale. BMJ 292 (6516), 344. https://doi.org/10.1136/bmj.292.6516.344 (1986).

    Google Scholar 

  33. Podsiadlo, D. & Richardson, S. The timed up and go: a test of basic functional mobility for frail elderly persons. J. Am. Geriatr. Soc. 39 (2), 142–148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x (1991).

    Google Scholar 

  34. Butland, R. J., Pang, J., Gross, E. R., Woodcock, A. A. & Geddes, D. M. Two-, six-, and 12-minute walking tests in respiratory disease. BMJ 284 (6329), 1607–1608. https://doi.org/10.1136/bmj.284.6329.1607 (1982).

    Google Scholar 

  35. Chiarotto, A. et al. Measurement properties of VAS, NRS, and the pain severity subscale of the brief pain inventory in patients with low back pain: a systematic review. J. Pain. 20 (3), 245–263. https://doi.org/10.1016/j.jpain.2018.07.009 (2019).

    Google Scholar 

  36. Alghadir, A., Anwer, S., Iqbal, A. & Iqbal, Z. Test–retest reliability, validity, and minimum detectable change of VAS, NRS and VRS for Osteoarthritic knee pain. J. Pain Res. 11, 851–856. https://doi.org/10.2147/JPR.S158847 (2018).

    Google Scholar 

  37. Yusoff, M. S. B. ABC of content validation and content validity index calculation. Educ. Med. J. 11 (2), 49–54. https://doi.org/10.21315/eimj2019.11.2.6 (2019).

    Google Scholar 

  38. World Medical Association. World medical association declaration of helsinki: ethical principles for medical research involving human subjects. JAMA 310 (20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 (2013).

    Google Scholar 

  39. Algarni, A. S., Ghorbel, S., Jones, J. G. & Guermazi, M. Validation of an Arabic version of the Oswestry index in Saudi Arabia. Ann. Phys. Rehabil Med. 57 (9–10), 653–663. https://doi.org/10.1016/j.rehab.2014.06.006 (2014).

    Google Scholar 

  40. Jenks, A. et al. RMDQ, ODI, and QBPDS: which has superior measurement properties in older adults with low back pain? J. Orthop. Sports Phys. Ther. 52 (7), 457–469. https://doi.org/10.2519/jospt.2022.10802 (2022).

    Google Scholar 

  41. Nicol/Oliveira/George. (refs 7–12) — multimodal recommendation cited in Results/Discussion (already listed; no duplicate entry).

  42. Rubinstein, S. M. et al. Benefits and harms of spinal manipulative therapy for chronic low back pain: systematic review and meta-analysis of RCTs. BMJ 364, l689. https://doi.org/10.1136/bmj.l689 (2019).

    Google Scholar 

  43. Thomas, J. S. et al. Effect of spinal manipulative and mobilization therapies in young adults with mild to moderate chronic low back pain. JAMA Netw. Open. 3 (8), e2012589. https://doi.org/10.1001/jamanetworkopen.2020.12589 (2020).

    Google Scholar 

  44. Guzmán Pavón, M. J. et al. Comparative effectiveness of manual therapy interventions on pain and pressure pain threshold in patients with myofascial trigger points. Clin. J. Pain. 38 (12), 749–760. https://doi.org/10.1097/AJP.0000000000001079 (2022).

    Google Scholar 

  45. Pensri, P., Foster, N. E., Srisuk, S., Baxter, G. D. & McDonough, S. M. Physiotherapy management of low back pain in thailand: a study of practice. Physiother Res. Int. 10 (4), 201–212. https://doi.org/10.1002/pri.16 (2005).

    Google Scholar 

  46. Poitras, S., Blais, R., Swaine, B. & Rossignol, M. Practice patterns of physiotherapists in the treatment of work-related back pain. J. Eval Clin. Pract. 13 (3), 412–421. https://doi.org/10.1111/j.1365-2753.2006.00725.x (2007).

    Google Scholar 

  47. Ladeira, C. E., Cheng, M. S. & da Silva, R. A. Clinical specialization and adherence to Evidence-Based practice guidelines for low back pain management: A survey of US physical therapists. J. Orthop. Sports Phys. Ther. 47 (5), 347–358. https://doi.org/10.2519/jospt.2017.6561 (2017).

    Google Scholar 

  48. Agnus Tom, A., Rajkumar, E., John, R. & Joshua George, A. Determinants of quality of life in individuals with chronic low back pain: a systematic review. Health Psychol. Behav. Med. 10 (1), 124–144. https://doi.org/10.1080/21642850.2021.2022487 (2022).

    Google Scholar 

  49. Maughan, E. F. & Lewis, J. S. Outcome measures in chronic low back pain. Eur. Spine J. 19 (9), 1484–1494. https://doi.org/10.1007/s00586-010-1353-6 (2010).

    Google Scholar 

  50. Hansen, A., Nim, C. G., O’Sullivan, K. & O’Neill, S. Testing walking performance in patients with low back pain: will two minutes do instead of six minutes? Disabil. Rehabil. 46 (6), 1173–1177. https://doi.org/10.1080/09638288.2023.2194683 (2024).

    Google Scholar 

  51. Alanazi, F., Gleeson, P., Olson, S. & Roddey, T. Translation and validation of the Arabic version of the Fear-Avoidance beliefs questionnaire in patients with low back pain. Spine (Phila Pa. 1976). 42 (7), E411–E416. https://doi.org/10.1097/BRS.0000000000001802 (2017).

    Google Scholar 

  52. Hallegraeff, J. M., Van Zweden, L., Oostendorp, R. A. & Van Trijffel, E. Psychological assessments by manual physiotherapists in the Netherlands in patients with nonspecific low back pain. J. Man. Manip Ther. 29 (5), 310–317. https://doi.org/10.1080/10669817.2021.1919283 (2021).

    Google Scholar 

  53. Holopainen, R., Piirainen, A., Karppinen, J., Linton, S. J. & O’Sullivan, P. Physiotherapists’ conceptions of learning and integrating cognitive functional therapy into clinical practice. Physiother Theory Pract. 38 (2), 309–326. https://doi.org/10.1080/09593985.2020.1753271 (2022).

    Google Scholar 

  54. Mourad, F. et al. Knowledge, beliefs, and attitudes of spinal manipulation: a cross-sectional survey of Italian physiotherapists. Chiropr. Man. Th. 30 (1), 33. https://doi.org/10.1186/s12998-022-00449-x (2022).

    Google Scholar 

  55. Ali, M., Uddin, Z. & Hossain, A. Clinical practice pattern of managing low back pain among physiotherapists in bangladesh: a cross-sectional study. Physiother Pract. Res. 43 (2), 93–100 (2022). (If volume/pages differ in your thesis file, keep your originals.).

    Google Scholar 

  56. Anggiat, L. & Rahmansyah, B. Trends in the use of manual therapy among physiotherapists in jakarta: a survey study. Int. J. Sport Exerc. Health Res. 6 (2), 121–125. https://doi.org/10.31254/sportmed.6205 (2022).

    Google Scholar 

  57. Chavula, G. Level of knowledge and practice of manual therapy among physiotherapy practitioners at the university teaching Hospital, Lusaka, Zambia. Int. J. Clin. Exp. Med. Res. 6 (2), 103–110. https://doi.org/10.26855/ijcemr.2022.04.001 (2022).

    Google Scholar 

  58. Hamm, L. et al. Danish physiotherapists’ management of low back pain. Adv. Physiother. 5 (3), 125–131 (2003).

    Google Scholar 

  59. Poitras, S., Blais, R., Swaine, B. & Rossignol, M. Management of work-related low back pain: a population-based survey of physical therapists. Phys. Ther. 85 (11), 1168–1181 (2005).

    Google Scholar 

  60. Rubinstein, S. M. & van Tulder, M. A best-evidence review of diagnostic procedures for neck and low-back pain. Best Pract. Res. Clin. Rheumatol. 22 (3), 471–482. https://doi.org/10.1016/j.berh.2007.12.003 (2008).

    Google Scholar 

  61. Anderson, D. B. & Shaheed, C. A. Medications for treating low back pain in adults: overview for musculoskeletal clinicians. J. Orthop. Sports Phys. Ther. 52 (7), 425–431. https://doi.org/10.2519/jospt.2022.10788 (2022).

    Google Scholar 

  62. Hiroshi, Takasaki Takahiro, Ueno Japanese Clinical Physical Therapists With the Mechanical Diagnosis and Therapy License Are More Competent and Confident in Pain Management Than Those Without It: A Cross-Sectional Study. Cureus. 16:e70652. https://doi.org/10.7759/cureus.70652 (2024).

  63. Birgitta, Widerström Eva, Rasmussen-Barr Carina, Boström. Aspects influencing clinical reasoning and decision-making when matching treatment to patients with low back pain in primary healthcare Musculoskeletal Science and Practice 416-14. http://doi.org/10.1016/j.msksp.2019.02.003 (2019).

    Google Scholar 

  64. Ismail, Saracoglu Meltem Isintas, Arik Emrah, Afsar Hasan Huseyin, Gokpinar. The effectiveness of pain neuroscience education combined with manual therapy and home exercise for chronic low back pain: A single-blind randomized controlled trial. Physiotherapy Theory and Practice. 38(7), 868-878. 10.1080/09593985.2020.1809046 (2022).

Download references

Acknowledgements

The authors extend their appreciation to the Ongoing Research Funding program – Research Chairs (ORF-RC-2025-1000), King Saud University, Riyadh, Saudi Arabia for funding this research.

Funding

This study was funded by the Ongoing Research Funding program – Research Chairs (ORF-RC-2025-1000), King Saud University, Riyadh, Saudi Arabia. The funding body played no role in the design, execution, analysis and interpretation of data, or writing of the study.

Author information

Authors and Affiliations

  1. Rehabilitation Research Chair, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, 11433, Riyadh, Saudi Arabia

    Yahya M. Zubayni, Amir Iqbal & Ahmad H. Alghadir

  2. Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, 11433, Riyadh, Saudi Arabia

    Saad A. Alhammad, Faris A. Alodaibi & Abdulfattah S. Alqahtani

Authors
  1. Yahya M. Zubayni
    View author publications

    Search author on:PubMed Google Scholar

  2. Saad A. Alhammad
    View author publications

    Search author on:PubMed Google Scholar

  3. Faris A. Alodaibi
    View author publications

    Search author on:PubMed Google Scholar

  4. Abdulfattah S. Alqahtani
    View author publications

    Search author on:PubMed Google Scholar

  5. Amir Iqbal
    View author publications

    Search author on:PubMed Google Scholar

  6. Ahmad H. Alghadir
    View author publications

    Search author on:PubMed Google Scholar

Contributions

Y.M.Z. A.H.A. S.A.A. F.A.A. A.S.A. and A.I. proposed the study conception and design. Y.M.Z. A.H.A and A.I. completed the methodological work and collected data. Y.M.Z. A.H.A. S.A.A. F.A.A. A.S.A. and A.I. contributed to the data analysis and its interpretation. Y.M.Z. and A.I. prepared the manuscript’s initial draft. Y.M.Z. A.H.A. S.A.A. F.A.A. A.S.A. and A.I. critically reviewed and edited the manuscript’s intellectual content. All authors read and approved the manuscript’s final version to be submitted or published and took responsibility for the intellectual content of the same manuscript.

Corresponding author

Correspondence to Amir Iqbal.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

Ethical approval for this study was conducted by the Institutional Review Board Ethics Committee of the College of Medicine at King Saud University (approval number 25/0010/IRB on 07/01/2025). The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki (2010). All participants were informed about the purpose of the study, assured of confidentiality, and provided written consent prior to participation. Participation was voluntary, and respondents could withdraw at any time without consequence.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zubayni, Y.M., Alhammad, S.A., Alodaibi, F.A. et al. Utilization patterns and perceived effectiveness of manual therapy for low back pain among Saudi physical therapists: a national cross-sectional study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-38025-5

Download citation

  • Received: 28 November 2025

  • Accepted: 28 January 2026

  • Published: 12 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-38025-5

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Keywords

  • Low back pain
  • Manual therapy
  • Physical therapists
  • Training exposure
  • Perceived effectiveness
  • Utilization patterns
  • Saudi Arabia
Download PDF

Advertisement

Explore content

  • Research articles
  • News & Comment
  • Collections
  • Subjects
  • Follow us on Facebook
  • Follow us on X
  • Sign up for alerts
  • RSS feed

About the journal

  • About Scientific Reports
  • Contact
  • Journal policies
  • Guide to referees
  • Calls for Papers
  • Editor's Choice
  • Journal highlights
  • Open Access Fees and Funding

Publish with us

  • For authors
  • Language editing services
  • Open access funding
  • Submit manuscript

Search

Advanced search

Quick links

  • Explore articles by subject
  • Find a job
  • Guide to authors
  • Editorial policies

Scientific Reports (Sci Rep)

ISSN 2045-2322 (online)

nature.com sitemap

About Nature Portfolio

  • About us
  • Press releases
  • Press office
  • Contact us

Discover content

  • Journals A-Z
  • Articles by subject
  • protocols.io
  • Nature Index

Publishing policies

  • Nature portfolio policies
  • Open access

Author & Researcher services

  • Reprints & permissions
  • Research data
  • Language editing
  • Scientific editing
  • Nature Masterclasses
  • Research Solutions

Libraries & institutions

  • Librarian service & tools
  • Librarian portal
  • Open research
  • Recommend to library

Advertising & partnerships

  • Advertising
  • Partnerships & Services
  • Media kits
  • Branded content

Professional development

  • Nature Awards
  • Nature Careers
  • Nature Conferences

Regional websites

  • Nature Africa
  • Nature China
  • Nature India
  • Nature Japan
  • Nature Middle East
  • Privacy Policy
  • Use of cookies
  • Legal notice
  • Accessibility statement
  • Terms & Conditions
  • Your US state privacy rights
Springer Nature

© 2026 Springer Nature Limited

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing