Short-Term Effect of Plumb Line Correction and Shockwave Therapy on Acute Low Back Pain: A Retrospective Single-Arm Observational Study in a Primary Care Clinic

Purpose: This study was performed to evaluate the short-term clinical effects of combining extracorporeal shockwave therapy (ESWT) and corrective exercise on plumb line deviation and pain reduction in patients with acute low back pain (LBP).Methods: A retrospective single-arm study was conducted involving 20 adult patients (mean age, 41.7 years) with acute LBP and confirmed plumb line deviation on full-spine lateral radiographs.All patients underwent a standardized 4-week treatment protocol consisting of focused and radial ESWT applied to the iliopsoas and erector spinae muscles, along with corrective exercises targeting hip flexor flexibility and core stabilization.Sagittal spinal alignment was assessed by measuring the horizontal plumb line deviation from C7 to the sacral promontory.Pain intensity was evaluated using the visual analogue scale (VAS).Paired t-tests were used for statistical analysis.Results: The mean plumb line deviation improved significantly from -4.21.1 cm before treatment to -1.30.9 cm after treatment (p 0.001), indicating a shift toward sagittal balance.VAS scores decreased significantly from 7.81.2 to 1.41.1 (p 0.001).Improvements were consistent across subgroups regardless of age, sex, or baseline misalignment.No adverse events or complications were observed during the study period.Conclusion: A short-term, combined approach using ESWT and corrective exercise significantly improved sagittal alignment and reduced pain in patients with acute LBP.This noninvasive strategy may serve as an effective treatment option in primary care settings.Full-spine radiographic assessment with plumb line analysis offers objective insight into therapeutic outcomes.