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Abstract
Objective
Chronic low back pain (CLBP) has remained a major contributor to disability worldwide, with significant physical, psychological, and socioeconomic consequences. The objective of this clinical trial was to evaluate and compare the effectiveness of three commonly used physiotherapy interventions—manual therapy, exercise therapy, and electrotherapy—on pain reduction, functional improvement, and quality of life among patients with chronic low back pain treated at a tertiary care hospital in the northeastern region of Pakistan.
Methods
A randomized controlled clinical trial was conducted at a tertiary care teaching hospital in northeastern Pakistan. Adult patients diagnosed with chronic low back pain lasting longer than 12 weeks were enrolled and randomly assigned into three intervention groups: manual therapy, exercise therapy, and electrotherapy. Each intervention was administered over a 12-week treatment period under standardized clinical protocols. Pain intensity was assessed using the Visual Analog Scale (VAS), functional disability was measured with the Oswestry Disability Index (ODI), and quality of life was evaluated using the Short Form-36 (SF-36) questionnaire. Baseline and post-intervention assessments were compared within and between groups using appropriate statistical analyses.
Results
All three physiotherapy interventions demonstrated statistically significant improvements in pain intensity, functional ability, and quality of life following the treatment period (p < 0.05). Exercise therapy produced the greatest reduction in pain scores and disability levels, followed by manual therapy. Electrotherapy showed moderate improvement but was less effective in sustaining long-term functional gains. Improvements in physical functioning and vitality domains of SF-36 were most pronounced in the exercise therapy group. No serious adverse events were reported during the study.
Conclusion
The findings of this clinical trial indicated that physiotherapy interventions were effective in managing chronic low back pain. Among the studied modalities, exercise therapy emerged as the most beneficial intervention for long-term pain management and functional recovery. These results supported the integration of structured exercise-based physiotherapy programs into routine clinical practice for chronic low back pain, particularly in resource-limited healthcare settings.