Ischemic Compression and Low-Level Laser Therapy for Myofascial Low Back Pain

This randomized controlled study will compare the effects of ischemic compression combined with exercise, low-level laser therapy combined with exercise, and sham low-level laser therapy combined with exercise in adults with subacute or chronic myofascial low back pain. Participants will be assigned to one of three treatment groups. Outcomes will include pain intensity measured using the Visual Analog Scale (VAS), pressure pain threshold (PPT), and disability measured using the Oswestry Disability Index (ODI). Outcomes will be assessed at baseline, 3 weeks, 6 weeks, and at a 1-month follow-up.

Inclusion Criteria: * Adults aged 18-80 years * Diagnosis of myofascial low back pain * Presence of active myofascial trigger point(s) in the lumbar region * Ability to understand and follow study procedures * Willingness to participate and provide written informed consent Exclusion Criteria: * Pregnancy or lactation * Photosensitivity or known sensitivity to light-based therapy * Pacemaker use * Malignancy or suspected malignancy, particularly in the treatment area * Skin lesions, active infection, or open wounds in the lumbar treatment area * History of lumbar spine surgery or spinal fracture * Neurological disorders that may affect study participation or outcome assessment * Serious systemic disease that may interfere with participation or treatment safety * Current physical therapy treatment for low back pain * Corticosteroid injection within the previous 3 months * Any contraindication to low-level laser therapy or ischemic compression