Objectives:

To investigate the efficacy of a standardized high-intensity laser therapy (HILT) protocol combined with motor control exercise (MCE) compared to sham HILT plus MCE in individuals with radicular low back pain secondary to lumbosacral disc herniation.

Methods:

Thirty-six participants were randomly assigned to receive either active HILT or sham HILT, both combined with MCE, over a 4-week intervention period. The primary outcome was lumbosacral pain intensity assessed using the Visual Analogue Scale (VAS). Secondary outcomes included radicular pain intensity (VAS), functional disability (Oswestry Disability Index, ODI), lumbar flexion range of motion (ROM) via the modified-modified Schober test (MMST), straight leg raise (SLR) ROM, and tibial nerve pressure pain threshold (PPT). Outcomes were assessed at baseline, post-treatment, and at a 1-month follow-up.

Results:

Compared with the sham HILT group, the active HILT group demonstrated significantly greater reductions in lumbosacral pain post-treatment (MD=−2.05; 95%CI:−3.22 to −0.87; P=0.002) and at follow-up (MD=−1.98; 95%CI: −3.43 to −0.53; P=0.013). Functional disability improved significantly only at follow-up (MD=−12.07; P=0.014). SLR range of motion showed significant improvements post-treatment and follow-up (d=1.90). Tibial nerve PPT improved significantly at follow-up (P=0.030).

Conclusions:

HILT combined with MCE is more effective than MCE alone in reducing pain and improving function and mobility in patients with radicular low back pain.

Trial Registration: ClinicalTrials.gov, NCT06151704.

KEY WORDS: Laser Therapy; disc herniation; sciatica; low back pain.

Level of Evidence: I