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Background/Aim. The main clinical phenomena in acute low back pain (LBP) with  radiculopathy are pain and neurological disorders. Although some studies show  that low level laser therapy (LLLT) has the ability to modulate inflammatory  processes and relieve acute pain condition, the laser therapy dose protocol  has not been yet completely established. The aim of this study was to  investigate the effects of three different energy doses of LLLT in patients  with acute LBP and radiculopathy. Methods. The study included 66 patients  with acute LBP and radiculopathy who had been randomly divided into three  groups (22 patients each) received three different doses of LLLT. The  patients were treated 5 times weekly, for a total of 10 treatments, with the  following parameters: wave length 904 nm, frequency 3,000 Hz, average diode  power 25 mW; energy dose of 0.1 J per point in the first group, 1 J per point  in the second and 4 J per point in the third group; daily treatment time and  accumulated energy were 16 s and 0.4 J in the first group, 160 s and 4 J in  the second group and 640 s and 16 J in the third group, respectively. The  parameters of assessment before and after the therapy were: lumbar and leg  pain measured by visual analogue scale (VAS), local and general functional  changes (Schober test, manual muscle test, straight leg raise test and the  modified North American Spine Society-Low Back Pain Outcome Instrument-NASS  LBP). Results. Highly significant improvements (p < 0.01) were noted in all  the groups after LLLT with respect to all the investigated parameters. The  VAS scores were significantly lower in all the groups without a difference  between the groups (p > 0,05). Functional improvements were better in the  third group treated with the dose of 4 J per point than in other two groups  (p < 0.05). Conclusions. Three different energy doses of LLLT were equally  effective in alleviating lumbar and leg pain without side effects, but the  dose of 4 J per point seemed to be more effective in improving the activities  of daily living and lumbar mobility

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Clinical and functional evaluation of patients with acute low back pain and radiculopathy treated with different energy doses of low level laser therapy