Understanding and management of low back pain: A qualitative study of perceptions of traditional healers at the Warwick Muthi Market in Durban, South Africa

Abstract

The treatments, assessment and management strategies related to low back pain (LBP) developed for the western world may have limited relevance for traditional healing. This study explored the management of LBP symptoms by traditional healers at the Warwick Muthi Market in Durban. Using a qualitative method, semi-structured interviews were conducted with ten traditional healers. The gender of participants was equally distributed with the sample comprising 5 males and 5 females. The study found that traditional healers understand LBP in terms of the physical symptoms that a person may present. Traditional belief in LBP takes into account the cultural and biopsychosocial aspects of pain. Traditional healers reported various causes of LBP including ilumbo (a sexually transmitted disease, particularly affecting the youth, mainly males. It is characterised by penile sores, discharge, low sex drive and marked inguinal lymphadenopathy and is difficult to treat), umeqo (a form of witchcraft in which sickness is believed to be caused by walking or stepping over a traditional medicine), ancestors/culture, kidney disease and ageing. In addition, they tended to personalise the causes of LBP and the reason for becoming ill was often sought in the supernatural realm with the only remedy for such diseases being traditional treatment. The traditional healers described various treatments or management strategies for LBP, including plant remedies and certain animal extracts (animal fats). Other substances as well as specific rituals and traditional techniques and methods were also mentioned. These included making incisions in the painful areas (ukugcaba) and bowel cleansing (ukuchatha). Various plants and herbs commonly used for LBP symptoms were mentioned, such as roots and bark which may have certain healing properties and play a role in the treatment of LBP. The study concluded that traditional healers understand LBP in terms of its biopsychosocial nature, while their management and treatment of LBP focus holistically on this complex pain disorder.

Keywords: Low back pain, traditional healers, traditional medicine.