A Randomized, Double-Blind Study on the Combined Effects of Low-Level Laser Therapy and Exercise on Pain, Functional Level, and Range of Motion in Patients with Chronic Non-Specific Low Back Pain

Abstract

OBJECTIVE: To investigate the combined effects of low-level laser therapy (LLLT) in conjunction with an exercise program (LLLT group) compared to exercise alone (control group) on pain, functional level, and range of motion in patients with chronic non-specific low back pain (CNLBP).METHODS: Sixty participants with CNLBP were randomized and divided into 2 groups: laser group (30 participants) and control group (30 participants). Both groups were assigned the same homework exercises (once a day, 3 days a week for 4 weeks). The assessments were performed at baseline and 4 weeks after low-level laser therapy application 3 times per week for 4 weeks. Pain level (visual analogue scale), functional level (the Oswestry low back pain disability questionnaires Thai version) and range of motion (Schober’s test) were evaluated.RESULTS: The participants who completed the study totaled 60, with 30 in the LLLT group and 30 in the control group. Both groups showed statistically significant differences in improved pain level and functional level (p < 0.001) from baseline to the 4th week, with the exception of range of motion in the control group (p = 0.644). Outcome of mean difference across the intervention arm for group comparison analysis indicated statistically significant differences in favor of the experimental group across all measures (p < 0.01, p < 0.03 and p < 0.01, respectively).CONCLUSION: Combining LLLT with exercise significantly reduced pain, improved functional ability, and increased lumbar range of motion, providing a more effective treatment for Thai patients with CNLBP compared to exercise alone. The Minimal Clinically Important Difference for Visual Analog Scale (0.211) and Oswestry Disability Index (0.216) confirmed that the improvements at week 4 were clinically significant beyond natural recovery.