Effect of High-Power Laser Acupuncture on Fatigue and Proprioception in Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial

Objective: To examine the effects of adding high-power laser acupuncture (HPLA) to an exercise program on back muscular fatigability and endurance, lumbar proprioception, pain severity, and pain-related self-efficacy in chronic nonspecific low back pain (CNLBP) patients. Methods: Sixty adults with CNLBP aged 20– 40 years enrolled in this double-blind, randomized sham-controlled trial with equal and random assignment to receive HPLA plus exercise therapy or sham laser plus the same exercise therapy three times weekly over a six-week period. Back muscle fatigue and lumbar proprioception were assessed by an isokinetic dynamometer; endurance by the Biering–Sørensen test; pain severity by the visual analog scale; and pain-related self-efficacy using the Arabic Pain Self-Efficacy Questionnaire. Evaluations were carried out both before and just after the six-week intervention. Results: Within-group analyses demonstrated significant improvements across all outcomes in each group. Between-group analyses revealed significantly greater improvements in the HPLA treatment group across all measured variables ( P < 0.05). At post-intervention, the HPLA group demonstrated a greater number of repetitions to fatigue (mean difference [MD] = 7.10 repetitions; 95% CI: 3.42 to 10.78) and lower lumbar proprioceptive error (MD = − 1.27°; 95% CI: − 1.60 to − 0.93) compared with the sham group. Conclusion: In cases of CNLBP, adding HPLA as an adjunct to exercise therapy may improve back muscle fatigue, endurance, lumbar proprioception, pain severity, and pain self-efficacy over a six-week intervention period. However, these short-term improvements require confirmation through longitudinal follow-up studies. Future research should emphasise dose response and long-term effects. Keywords: low back pain, laser acupuncture, muscular endurance, muscular fatigue, proprioception