Rehabilitation of Chronic Non-Specific Low Back Pain: A Case Report

INTRODUCTION AND PURPOSE Chronic non-specific low back pain (CNSLBP) often presents challenges in management, especially in sedentary office workers. This case report presents the physical therapy management of a 30-year-old sedentary office worker with chronic low back pain (LBP), using a multimodal rehabilitation program including H-Wave® device stimulation, manual therapy, education, and active exercise intervention. While H-Wave® stimulation has been studied in chronic pain, its use in CNSLBP among office workers remains limited. Rather than demonstrating a novel intervention, this case report emphasizes a practical, guideline-based multimodal rehabilitation for CNSLBP in a sedentary office worker, highlighting the extent of therapy, real-world implementation, ergonomic intervention, and clinical reasoning for improved long-term outcomes. PRESENTATION The patient is a 30-year-old female office employee who presented to the physical therapy clinic with a 6-month history of LBP, aggravated by prolonged sitting. She rated her pain 6/10 on the Visual Analog Scale (VAS), which significantly affected her daily activities. Clinical assessment showed lumbar stiffness, poor core stability, and decreased range of motion (ROM). Postural evaluation identified anterior pelvic tilt, forward head posture, and increased lumbar lordosis. CONCLUSION This case illustrates the practical application of a guideline-based, multimodal rehabilitation program, rather than proposing a new therapy. The integration of manual therapy, education, active exercise, and ergonomics demonstrated significant reductions in symptoms and improvements in functional impairment. Importantly, the case also demonstrates the potential adjunctive value of H-Wave device stimulation within multimodal care, while acknowledging that the current evidence is modest compared to standard electrotherapies, such as transcutaneous electrical nerve stimulation (TENS) or interferential current (therapy) (IFC). Ergonomic modifications and posture retraining were integral to sustaining improvements in this sedentary worker, illustrating the importance of individualized, real-world rehabilitation strategies.

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