Effectiveness of monopolar diathermy by radiofrequency combined with exercise in patients with chronic low back pain: A randomized clinical trial

BackgroundChronic low back pain can severely affect quality of life. While several treatments are available, the combination of therapies often results in better outcomes.ObjectiveThis study delves into the comparative effectiveness of combining monopolar dielectric diathermy radiofrequency (MDR) with supervised therapeutic exercise against the latter treatment alone.MethodsA randomized single-blind controlled trial was conducted. The intervention group (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mo>(</mml:mo><mml:mi>n</mml:mi><mml:mo>=</mml:mo><mml:mn>30</mml:mn><mml:mo>)</mml:mo></mml:math> 30) received MDR with supervised therapeutic exercises for eight weekly sessions for four weeks. The control group (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>n</mml:mi><mml:mo>=</mml:mo></mml:math> 30) received only the same exercise protocol. The following self-report measures were assessed before the first treatment session, at four, and 12 weeks: disability, pain, kinesiophobia, quality of life, sleep quality, emotional distress, isometric trunk strength, and trunk flexion range.ResultsRepeated ANOVA measures revealed significant time*group interactions for the McQuade test (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>p</mml:mi><mml:mo>=</mml:mo></mml:math> 0.003), the physical role (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>p</mml:mi><mml:mo>=</mml:mo></mml:math> 0.011), vitality (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>p</mml:mi><mml:mo>=</mml:mo></mml:math> 0.023), social function (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>p</mml:mi><mml:mo>=</mml:mo></mml:math> 0.006), and mental health subscales (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>p</mml:mi><mml:mo>=</mml:mo></mml:math> 0.042). Between-group analyses showed significant differences for all outcomes at each follow-up: RMDQ (post-treatment, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>p</mml:mi><mml:mo>=</mml:mo></mml:math> 0.040), ODI (post-treatment and 12-week, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>p</mml:mi><mml:mo>=</mml:mo></mml:math> 0.040), VAS (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>p</mml:mi><mml:mo><</mml:mo></mml:math> 0.001), TSK (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>p</mml:mi><mml:mo><</mml:mo></mml:math> 0.001), and McQuade Test (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>p</mml:mi><mml:mo><</mml:mo></mml:math> 0.020).ConclusionThe combination of diathermy radiofrequency with supervised therapeutic exercise significantly surpasses the efficacy of supervised therapeutic exercise alone, showcasing improvements in pain, disability, kinesiophobia, lumbar mobility in flexion, and overal quality of life in patients with chronic low back pain.