Abstract

Background: Low back pain (LBP) is one of the most prevalent musculoskeletal conditions worldwide and the leading cause of years lived with disability. In Saudi Arabia, LBP represents a substantial public health burden, particularly among working-age adults and occupational groups, yet the evidence regarding its prevalence and management remains fragmented. Aim: This systematic review aimed to synthesize published evidence on the prevalence of LBP in Saudi Arabia and to qualitatively examine reported approaches to its management within the Saudi healthcare system. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. Peer-reviewed studies conducted in Saudi Arabia reporting LBP prevalence and/or management-related outcomes were identified through database searching and manual reference screening. Eligible studies were screened in two stages and synthesized qualitatively due to heterogeneity in populations, definitions, and outcome measures. Results: Nine studies met inclusion criteria. Reported LBP prevalence ranged from 46.2% in community-based samples to over 70% among healthcare workers. Occupational groups, particularly teachers and healthcare professionals, consistently demonstrated higher prevalence and functional impact. Management-related studies highlighted gaps in standardized care pathways, underutilization of primary care and physiotherapy, variable adherence to clinical guidelines, and mixed alignment between patient preferences and evidence-based recommendations. Conclusion: Low back pain is highly prevalent in Saudi Arabia and is associated with significant functional and healthcare burden. Evidence suggests a need for improved implementation of guideline-based, primary-care–centered management pathways and greater integration of physiotherapy services to optimize outcomes and reduce unnecessary escalation of care.

Key words: Prevalence; Management; Low Back Pain; Saudi Arabia; Systematic Review