Prevalence, Patterns, Treatment Outcomes and Costs of Physiotherapy‐Managed Musculoskeletal Disorders in Nigeria

Abstract

BACKGROUND AND PURPOSE: Musculoskeletal disorders (MSDs) are a leading cause of global disability, yet data on physiotherapy-managed cases remain limited in Nigeria. This study aimed to assess the prevalence, patterns, treatment effectiveness and cost of physiotherapy for MSDs. METHODS: A 10-year retrospective study of all cases of MSDs at a Nigerian University Teaching Hospital was carried out. Data were gleaned on socio-demographics, types of MSDs, treatments given and costs. Real-world evidence for intervention on pain was calculated. Cost of care (direct and indirect) was estimated using the cost-of-illness approach. RESULTS: A total of 1582 patients were assessed, with a mean age of 47.8 ± 25.7 years, predominantly female (52.5%), and from middle (62.8%) and low (25.1%) socioeconomic classes. Over 10 years, 47.35% of physiotherapy-related conditions were MSDs, with low back pain (LBP) being the most common (21.6%) and osteoarthritis the least (6.3%). Strengthening exercises were the primary treatment (73.1%), followed by vertical oscillatory pressure (a manual therapy approach) (21.9%). Both interventions significantly reduced pain (p = 0.001). The total direct and indirect costs for MSDs were ₦9003 ± 7913 and ₦36,011 ± 31,652, equivalent to approximately $23.08 ± 20.29 and $92.34 ± 81.16, respectively, in a high-income country context. Cost analysis revealed that osteoarthritis had the highest direct and indirect costs, adjusted to $29.23 ± 32.75 and $116.91 ± 131.00, respectively, while LBP had the lowest ($14.42 ± 8.55 and $57.69 ± 34.21). Strengthening exercises had the highest treatment costs among interventions, with direct costs of $25.70 ± 22.20 and indirect costs of $102.81 ± 88.60. DISCUSSION: MSDs are highly prevalent among socio-economically disadvantaged groups in Nigeria, with LBP being the most common and least costly condition, and osteoarthritis the costliest; physiotherapy interventions are widely used, with strengthening exercises being the most frequently applied and effective intervention, though they also incur the highest treatment costs. Overall, physiotherapy interventions demonstrated significant pain reduction, with cost variations reflecting the type of condition and the modality used.