A Randomized Controlled Trial Investigating the Effect of Extracorporeal Shock Wave Therapy With Core Stability Exercises for Treatment of Chronic Non-Specific Back Pain in Jordanian University Students

Chronic non-specific back pain (CNSLBP) is a prevalent condition with multifactorial causes, often linked to muscular weakness, poor postural control, and soft tissue dysfunction. Extracorporeal Shock Wave Therapy (ESWT) and core stabilization exercises (CSEs) have emerged as effective, complementary, and non-invasive treatment modalities for managing this condition.

ESWT works by delivering high-energy acoustic waves to affected tissues, stimulating biological responses such as neovascularization, collagen synthesis, and reduction of inflammation and pain mediators. These effects help improve tissue healing, decrease muscle tension, and enhance local blood flow, ultimately reducing pain intensity and improving mobility.

On the other hand, CSEs target the deep stabilizing muscles of the spine-particularly the transversus abdominis, multifidus, and pelvic floor muscles-to restore spinal stability and improve posture, balance, and functional movement. Regular performance of these exercises strengthens the core, reduces mechanical stress on the lumbar structures, and prevents pain recurrence.

When combined, ESWT and CSEs provide synergistic benefits: ESWT offers rapid pain relief and tissue recovery, facilitating better participation in exercise programs, while CSEs ensure long-term spinal stability and functional improvement. Together, they form a comprehensive and evidence-based approach to reducing pain, enhancing physical function, and improving quality of life in individuals with chronic non-specific low back pain.