High- and Low-Frequency TENS with Paravertebral Ozone Therapy for Chronic Low Back Pain and Radiculopathy: A Pilot Study

Abstract

Background: Chronic low back pain (CLBP) with radiculopathy is a leading cause of disability worldwide. Conventional treatments generally have limited efficacy, high costs, and associated adverse effects. Objective: To evaluate the efficacy and safety of high-and low-frequency TENS (HLF-TENS) with paravertebral ozone therapy (POT)in chronic low back pain (CLBP) and radiculopathy. Methods: This non-randomized pilot study was conducted with 88 consecutive patients meeting the inclusion criteria. Participants underwent 12 sessions of combined HLF-TENS and POT, without a control group. Pain intensity, neuropathic symptoms, and disability were assessed using the Numeric Rating Scale (NRS); the modified Michigan Neuropathy Screening Instrument (MNSI), and the modified Oswestry Disability Index (ODI), respectively. Assessments were performed at baseline, midpoint, and post-treatment, with long-term follow-up (1–2 years) via telephone interviews. Results: The study included 35 men (40%) and 53 women (60%), mean age of 51.3 years (range 20–80). Post-treatment, 80% of participants showed statistically significant improvements in pain, neuropathic symptoms, and disability. Pain NRS scores decreased from 8.58 to 1.64, neuropathic symptom scores from 7.34 to 1.14, and ODI scores from 8.05 to 2.12 (p< 0.001). At long-term follow-up (1–2 years), 80% of respondents remained asymptomatic, with no adverse effects reported. Conclusions: The combination of HLF-TENS and POT significantly reduced pain, neuropathic symptoms, and disability in CLBP patients with radiculopathy. These findings suggest a promising, non-invasive treatment option; however, randomized controlled trials are necessary to confirm efficacy