Evaluation of the Effectiveness of Focused Radiofrequency (TECAR) Therapy on Pain, Disability, Function, and Quality of Life in Patients With Lumbar Disc Herniation

The study is planned as a prospective, randomized, double-blind trial. According to power analysis, 54 patients will be included to achieve 95% power. Eligible participants will be women or men aged 20-60 years who are diagnosed with lumbar disc herniation, have low back pain lasting longer than 12 weeks, present to the Ankara Bilkent City Hospital Physical Therapy and Rehabilitation Hospital as outpatients, and consent to participate in the study.

According to the study criteria, initial evaluations will be performed by a single Physical Medicine and Rehabilitation physician. Demographic data of eligible patients, including age, sex, height, weight, occupation, and systemic diseases, will be recorded.

Patients will be evaluated before treatment, immediately after treatment, and one month after the end of treatment using the following scales: Visual Analog Scale (VAS) for pain, Numeric Rating Scale (NRS), Quality of Life Scale (SF-36), Roland-Morris Disability Questionnaire, Oswestry Disability Index, Finger-to-Floor Distance Measurement, Beck Depression Inventory, and Lumbar Schober Test.

Patients will be divided into two groups. The first group will receive a home exercise program including lumbar active range of motion exercises and lumbar isometric strengthening exercises, performed five times per week for three weeks according to the level of movement restriction and pain severity, along with TECAR therapy applied by a technician for 20 minutes per session, three days per week, for a total of six sessions.

The second group will receive the same home exercise program-including lumbar active range of motion exercises and lumbar isometric strengthening exercises-performed five times per week for three weeks according to the level of movement restriction and pain severity, along with sham TECAR therapy applied by a technician for 20 minutes per session, three days per week, for a total of six sessions.

Inclusion criteria

• Having low back pain lasting longer than 12 weeks

Having a diagnosis of lumbar disc herniation (bulging, protruded, or extruded)

Being able to comply with the exercise program

Willingness to participate in the study Being between 20 and 60 years of age

Exclusion criteria

Being younger than 20 years or older than 60 years

Having a known and/or newly diagnosed malignancy

Presence of cardiac implants such as a pacemaker

Having inflammatory low back pain

Having absolute spinal stenosis (anteroposterior diameter of the spinal canal < 10 mm and anteroposterior diameter of the lateral recess < 3 mm)

History of surgery due to lumbar disc herniation, lumbar spinal stenosis, vertebral fracture, or similar conditions

Presence of lumbar spondylolisthesis

Patients with sequestered disc herniation

Patients with polyneuropathy

Patients with central pain following stroke

Patients with neurological deficits

Having a diagnosed neurodegenerative disease

Having a systemic musculoskeletal disease

Patients with acute deep vein thrombosis

Pregnancy

Presence of infection at the skin surface where treatment will be applied

Unexplained weight loss

Bladder and/or bowel incontinence

Having received physical therapy modalities or injections for low back pain within the last 1 month

Having cognitive impairment

Refusal to participate in the study

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