Comparison of the Effectiveness of Various Deep Heating Modalities in the Management of Chronic Low Back Pain

Chronic low back pain (CLBP) is one of the most prevalent musculoskeletal conditions, often leading to long-term disability, reduced quality of life, and significant socioeconomic burden. Deep heating modalities, such as microwave diathermy, shortwave diathermy, and therapeutic ultrasound, are widely used in physiotherapy practice to reduce pain, improve tissue extensibility, and enhance function. However, direct comparisons of these modalities in CLBP are limited.

This quasi-experimental, non-randomized, parallel-group study will allocate participants to one of four groups:

Microwave diathermy + standard lumbar exercise program

Shortwave diathermy + standard lumbar exercise program

Therapeutic ultrasound + standard lumbar exercise program

Standard lumbar exercise program only (control)

The allocation will be performed in a non-systematic manner without a formal randomization sequence. All participants will receive a standardized home-based lumbar stabilization exercise program, while the intervention groups will also receive their respective deep heating modality in 15 treatment sessions (5/week for 3 weeks).

Primary outcomes will include pain intensity (Visual Analog Scale) and functional disability (Oswestry Disability Index). Secondary outcomes will include kinesiophobia (Tampa Scale for Kinesiophobia) and quality of life (SF-12 PCS and MCS). Assessments will be conducted at baseline and week 3 (post-treatment).

Inclusion criteria

• Age 18-65 years

Diagnosis of non-specific CLBP >12 weeks

Able to participate in exercise program

Voluntary informed consent provided

Exclusion criteria

Specific spinal pathology (tumor, fracture, infection, inflammatory disease)

Lumbar surgery within last 12 months

Pregnancy

Pacemaker or implanted metallic/electronic devices

Neurological deficits

Skin lesions or contraindications to deep heating modalities

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