Abstract
Pakistan, the world’s fifth most populous country, faces a growing burden of low back pain (LBP) driven by population aging, occupational risks, and constrained health resources. This scoping review mapped clinical and epidemiological LBP research in Pakistan, summarizing prevalence, risk factors, outcome measures, and treatments, and identifying research gaps. Following JBI guidance and PRISMA-ScR, we searched PubMed, Embase, Scopus, CINAHL, Google Scholar, and PakMediNet for studies on Pakistani populations published up to 10 October 2023. Two reviewers independently screened and charted data. Of 1,176 records identified, 219 studies were included. Rehabilitation-focused research predominated (n=89, 40.6%), followed by correlational/risk-factor work (n=45, 20.5%), prevalence studies (n=41, 18.7%), medical management (n=17, 7.7%), diagnostic testing (n=14, 6.4%), surgical interventions (n=7, 3.2%), and outcome measurement (n=6, 2.7%). Reported LBP prevalence ranged from 36.7% to 87% across settings and definitions. Among intervention studies, manual therapy was most frequently investigated (n=39, 34.5%). Chronic LBP dominated the literature (n=126, 57.5%). Publication volume surged during 2021–2023 (54.3%). Several Urdu-language instruments exist (e.g., disability, fear-avoidance, catastrophising, self-efficacy), but psychological and social dimensions remain sparsely examined. LBP research in Pakistan is expanding yet remains skewed toward biomedical and rehabilitation models with limited attention to psychosocial factors and guideline-concordant, activity-based care. Future work should prioritize biopsychosocial frameworks, nationally representative epidemiology with standardized outcomes, and evaluations of education- and exercise-based interventions. Policymakers and health systems can catalyze progress by supporting balanced research agendas, workforce training in evidence-based practice, and culturally adapted patient education to enable comprehensive, guideline-informed LBP care.