Effect of Low Level Laser versus McKenzie Technique in Treatment of Chronic Low Back Pain Tarek F 1 , Osama FA 2 *, Mohamed S 2 and Ragia MK 3 1 MOH, Shoubra Public Hospital, Hospitals and Medical Centers, Cairo University, Egypt 2 National Institute of Laser Enhanced Sciences, Cairo University, Egypt 3 Faculty of Physical Therapy, Cairo University, Egypt * Corresponding author: Osama FA, National Institute of Laser Enhanced Sciences, Cairo University, Egypt, Tel: 20 2 35676105; E-mail: o.fekry@hotmail.com Received date: May 5, 2017; Accepted date: May 16, 2017; Published date: May 25, 2017 Copyright: © 2017 Tarek F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. Abstract Background: Lower back pain refers to the pain and discomfort, which is usually, localized in between costal margin and inferior gluteal folds. Occasionally it is accompanied with pain in the leg too. Patients: Forty five patients with chronic low back pain (mean age 40.5±years, height 167±cm, weight 82.5±kg, and BM 29±kg/m 2 ) participated in this study. Patients and methods: Patients were categorized into 3 different equal groups (15 nos); group (A) received low level laser, group (B) received McKenzie technique and group(C) received traditional electrotherapy and functioned as the control group. Data of visual analogue scale (VAS), patient specific functional Scale and (ROM) scores were collected from each patient pre and post the administration of physiotherapy. Results: Statistical analysis using paired student t-test and unpaired student t-test showed significant differences in the VAS and PSFS values recorded pre and post treatment in both groups A and B. There was significant difference in improvement in pain; ROM and functional disability in laser group (A) than in McKenzie technique group (B). Conclusion: The physiotherapy program is not only effective for the patients having chronic lower back pain, it also helped in improving functional disability of the patients, especially when low level laser or McKenzie technique are added to the treatment program. Keywords: McKenzie technique; Peripheral nociceptors; Proliferation; musculoskeletal Introduction Lower back pain is denoted by the pain and discomfort occurred in between the costal margin and inferior gluteal folds. Oten, this pain is also accompanied by varied level of leg pain. Acute incidences of low back pain persist for less than 6 weeks. he sub-acute low back pain usually persists till 6 to 12 weeks; the chronic type of lower back pain is known to persist 12 weeks or more depending on the condition [1]. he Low Level Laser (LLL) treatment accelerates the overall healing process through interaction with the targeted tissues while using precise wavelengths of light. Implementation of this treatment regime can be done for those patients who are sufering from various degree of acute to chronic conditions. his treatment may aid in eliminating the pain, reducing the existing swelling and spasms and restoring the normal body functionality and movement [2]. LLL may reduce pain by two mechanisms 1- Anti-inlammatory -LLL reduces oxidative stress: Oxidative stress is generally caused through the stress causing to the mitochondria or tissues which remains in the ischemic conditions and in turn produces nitric oxide. In the cascading step of the process, this released nitric oxide binds with the cytochrome oxidase enzyme through a competitive inhibiting binding mode while replacing the oxygen molecule. As a consequence of this cellular event reduction in ATP production occurs. his whole scenario of the stress induction and modulation is also related to other conditions including speciic wavelength of light etc. All these factors involved determine the functioning rate of cytochrome c oxidase and helps in increasing the ATP production and diminishing the oxidative stress. A series of molecular events pertaining to the downstream metabolic efects allows the reduction of the interleukin 1ƍ, prostaglandin E2, tumor necrosis factor ƌ and other inlammatory markers [3]. Nerve blockage by 2- analgesia- LLL: Induction of analgesic efect can be augmented by comparatively higher irradiance energy based treatment which is physiologically happened through the disruption of the axonal transport in the small ibers like nociceptors. In this process there is a transient inhibition occurs in transmission of A-delta and C iber. Aferent inputs from these peripheral nociceptors become diminished and allow modulation of the reorganization of the synaptic connections. hus, central sensitization can be lowered through repetitive treatment regime [2]. Journal of Bioengineering & Biomedical Science Tarek, et al., J Bioengineer & Biomedical Sci 2017, 7:2 DOI: 10.4172/2155-9538.1000228 Research Article OMICS International J Bioengineer & Biomedical Sci, an open access journal ISSN: 2155-9538 Volume 7 • Issue 2 • 1000228