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Low Back PainCPRTLBPNCT07399145

Comparison of Prolotherapy and Rehabilitation Treatments in Low Back Pain (CPRTLBP)

A study testing Prolotherapy, Balneotherapy plus Physiotherapy and Physiotherapy in people with Low Back Pain, run by Balnear and Rehabilitation Sanatorium Techirghiol at 1 site in Romania.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Chronic low back pain (CLBP) represents one of the leading causes of long-term disability among adults and places a substantial strain on healthcare systems globally. The clinical course of CLBP is highly heterogeneous, with considerable variability in symptom persistence and functional impairment, which complicates… Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Low Back Pain
What is being tested?
Prolotherapy, Balneotherapy plus Physiotherapy and Physiotherapy
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
84 participants
Where
1 siteRomania
Study dates
1 Apr 2025to 15 Dec 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Clinical diagnosis of CLBP lasting more than three months, confirmed by lumbar radiography or magnetic resonance imaging
  • Pain intensity of at least 4 on the Visual Analog Scale
  • Age between 18 and 70 years
  • Patients who can comply with the study protocol and scheduled evaluations
  • Patients who provided written informed consent before participation

Who cannot join

  • Lumbar disc herniation with surgical indication or severe radiculopathy
  • Active infections
  • Systemic inflammatory or autoimmune diseases
  • A history of allergy to substances used in dextrose prolotherapy
  • Contraindications to balneotherapy, such as severe cardiovascular disease, renal insufficiency, or severe dermatological conditions
  • Prior prolotherapy or balneotherapy within six months before enrollment
Show all 13Show fewer
  • Decompensated chronic cardiovascular, hepatic, renal, respiratory, or neurological diseases at the time of inclusion
  • Pregnancy
  • Breastfeeding
  • Active neoplastic disease
  • Decompensated psychiatric disorders
  • Allergies to natural therapeutic factors that could lead to treatment interruption
  • Refusal to participate in the study

Trial locations and contacts

1 site in 1 country.

Romania1 site
  • Balneal and Rehabilitation Sanatorium of Techirghiol

    Constanța, Techirghiol, 906100

Other trials in Romania

About this study

Official title: Comparison of the Effects of Prolotherapy and Rehabilitation Treatments in Low Back Pain

Chronic low back pain (CLBP) represents one of the leading causes of long-term disability among adults and places a substantial strain on healthcare systems globally. The clinical course of CLBP is highly heterogeneous, with considerable variability in symptom persistence and functional impairment, which complicates therapeutic decision-making in routine practice.

Conventional physiotherapy is commonly prescribed for patients with CLBP; however, evidence comparing its short-term effectiveness with alternative interventions such as balneotherapy and prolotherapy remains scarce. Balneotherapy, often used as an adjunct to physiotherapy, is widely applied in the management of chronic musculoskeletal conditions and is believed to provide therapeutic benefits through a combination of thermal and mechanical effects.

Read more

In addition, psychosocial factors play a crucial role in the evolution of low back pain. Increased stress, insufficient social support, occupational dissatisfaction, and mood disorders have been associated with a higher likelihood of pain chronicification and reduced response to treatment.

The objective of the present study was to evaluate and compare short-term clinical outcomes of standard physiotherapy, combined balneotherapy and physiotherapy, and prolotherapy in individuals with chronic low back pain. Outcomes were assessed using validated instruments measuring pain severity, functional disability, lumbar spine mobility, quality of life, and psychological well-being at baseline and after a four-week intervention period.

The study enrolled adults aged 18 to 70 years with CLBP persisting for more than three months and a baseline Visual Analog Scale (VAS) score of at least 4. Participants were assigned to one of three treatment modalities: physiotherapy alone, balneotherapy combined with physiotherapy, or prolotherapy. Participants allocated to the dextrose prolotherapy group (PG) and the standard physiotherapy control group (CG) were treated at Ovidius Clinical Hospital, Romania, while patients included in the balneotherapy plus physiotherapy group (BG) underwent treatment at the Balneal and Rehabilitation Sanatorium Techirghiol, Romania. Evaluations were conducted at baseline (T0) and at the four-week follow-up (T1), encompassing measures of pain intensity, functional limitation, lumbar mobility, quality of life, and psychological status.

The results highlight the potential benefits of multimodal and regenerative therapeutic approaches within personalized conservative treatment strategies for patients with chronic low back pain.

Conditions
Low Back Pain
Being tested
Prolotherapy, Balneotherapy plus Physiotherapy, Physiotherapy
Keywords
chronic low back pain, physiotherapy, balneotherapy, prolotherapy, pain assessment, functional disability, quality of life
Medical subject headings
Low Back Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ProlotherapyOther

    A volume of 1 mL of prolotherapy solution was administered at each injection site. The injected solution consisted of a 1:1 dilution of 33% dextrose and 1% lidocaine, resulting in a final dextrose concentration of 16.5%. This formulation was used consistently across all injection sites to ensure standardized delivery and reproducibility of the therapeutic effect. All infiltration procedures were performed under strict aseptic conditions. The interventions were conducted under intravenous analgosedation, using a single-dose regimen of midazolam (2 mg), propofol (approximately 60 mg), and fentanyl (0.1 mg), administered to ensure patient comfort and procedural compliance. After each treatment session, patients were observed clinically to monitor for any immediate adverse events or procedure-related complications.

  • Balneotherapy plus PhysiotherapyOther

    The intervention was based on the region's specific natural therapeutic resources and was conducted under continuous medical supervision. The treatment schedule included saline therapeutic pool baths combined with supervised exercise therapy and applications of sapropelic therapeutic mud, with sessions performed daily, five days per week.

    Alongside balneological treatments, patients received daily electrotherapy following a standardized protocol, which consisted of lumbar magnetotherapy, interferential current therapy, and therapeutic ultrasound.

    The rehabilitation program also incorporated daily massage therapy and supervised therapeutic exercises carried out in a dedicated rehabilitation gym.

  • PhysiotherapyOther

    The therapeutic program consisted of physiotherapy combined with structured exercise therapy targeting lumbar spine stabilization and mobility, along with electrotherapy and massage therapy. No balneological interventions or prolotherapy procedures were included in the management of this group.

Study groups in NCT07399145
Study groupRoleWhat they receive
Prolotherapy group (PG)ExperimentalThe prolotherapy intervention was delivered over three sessions, performed at three-week intervals. All procedures were performed bilaterally under continuous ultrasound guidance using a BK Medical Flex Focus 800 ultrasound system with a convex probe. The prolotherapy solution was administered at predefined anatomical sites identified sonographically, including one injection point corresponding to the piriformis muscle, five points along the iliac crests corresponding to ligamentous insertions, three points at the sacral level, and five points at the level of the lumbar transverse processes targeting paravertebral ligamentous insertions. In addition, five unilateral injections were performed at the level of the lumbar spinous processes. In total, 33 injection points were used per session.
Receives: Other: Prolotherapy
Balneotherapy plus Physiotherapy Group (BG)ExperimentalParticipants assigned to the balneotherapy group (BG) completed a structured two-week inpatient rehabilitation program comprising 10 treatment days at the Balneal and Rehabilitation Sanatorium Techirghiol, Romania.
Receives: Other: Balneotherapy plus Physiotherapy
Physiotherapy Control Group (CG)Active comparatorParticipants allocated to the control group (CG) were assessed and managed at the Ovidius Clinical Hospital in Romania, where they received a conventional conservative treatment program.
Receives: Other: Physiotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain intensity

    Pain intensity was assessed using the Visual Analog Scale (VAS). Participants were asked to rate their current pain intensity by marking a point on a 100-mm horizontal line, where 0 indicates "no pain", and 100 indicates "worst pain imaginable." The score was recorded in millimeters (mm). Outcome range and interpretation: Minimum value: 0, Maximum value: 100. Higher scores indicate worse pain intensity.

    Measured: Baseline and follow-up assessments were conducted at 4 weeks after treatment completion

Secondary outcomes (3)
  1. Functional disability

    Functional disability was assessed using the Roland-Morris Disability Questionnaire (RMDQ). The questionnaire consists of 24 items related to physical activities and daily functioning affected by low back pain. Participants were asked to mark each statement that applied to their condition on the day of assessment. Each marked item was scored 1 point, and unmarked items were scored 0 points. The total score was calculated by summing all marked items and is reported as a unitless score. Outcome range and interpretation: Minimum value: 0, Maximum value: 24. Higher scores indicate greater functional disability (worse outcome), while lower scores indicate less disability (better outcome).

    Measured: Baseline and follow-up assessments were conducted at 4 weeks after treatment completion

  2. Lumbar spine mobility

    Lumbar spine mobility was assessed using the Schober test. With the participant standing upright, a point was marked at the level of the lumbosacral junction (L5-S1), and a second point was marked 10 cm above the first mark. Participants were then asked to bend forward maximally, and the distance between the two marks was remeasured. The increase in distance during trunk flexion was recorded in centimeters (cm) and used as the measure of lumbar spine mobility. Outcome range and interpretation: Minimum value: 0 cm, Maximum value: depending on individual mobility. Higher values indicate greater lumbar spine mobility (better outcome), while lower values indicate reduced mobility (worse outcome).

    Measured: Baseline and follow-up assessments were conducted at 4 weeks after treatment completion

  3. Psychological status

    Psychological status was assessed using the Hospital Anxiety and Depression Scale (HADS), which consists of 14 items divided into two subscales: anxiety (HADS-A) and depression (HADS-D), each containing 7 items. Participants were asked to rate how they had been feeling over the previous week. Each item is scored on a 4-point Likert scale ranging from 0 to 3. Subscale scores were calculated by summing the relevant item scores and are reported as unitless scores.Outcome range and interpretation: HADS-A (Anxiety): Minimum value: 0, Maximum value: 21. Higher scores indicate greater anxiety severity (worse psychological status). HADS-D (Depression): Minimum value: 0, Maximum value: 21. Higher scores indicate greater depressive symptom severity (worse psychological status).

    Measured: Baseline and follow-up assessments were conducted at 4 weeks after treatment completion

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Feb 2026
  2. Study start1 Apr 2025
  3. Primary completion1 May 2025
  4. Study completion15 Dec 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
84 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07399145
Sponsor's protocol ID
StelianMociu
Acronym
CPRTLBP
Status last verified
Feb 2026
First submitted
28 Jan 2026
Last updated
10 Feb 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Antonelli M, Donelli D, Veronesi L, Vitale M, Pasquarella C. Clinical efficacy of medical hydrology: an umbrella review. Int J Biometeorol. 2021 Oct;65(10):1597-1614. doi: 10.1007/s00484-021-02133-w. Epub 2021 Apr 17.

    PubMed 33866427
  • Owen PJ, Miller CT, Mundell NL, Verswijveren SJJM, Tagliaferri SD, Brisby H, Bowe SJ, Belavy DL. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med. 2020 Nov;54(21):1279-1287. doi: 10.1136/bjsports-2019-100886. Epub 2019 Oct 30.

    PubMed 31666220
  • Anheyer D, Klose P, Koch AK, Haller H, Dobos G, Cramer H. Comparative efficacy of different exercise interventions in chronic non-specific low back pain: protocol of a systematic review and network meta-analysis. BMJ Open. 2020 Aug 5;10(8):e036050. doi: 10.1136/bmjopen-2019-036050.

    PubMed 32759244
  • Linton SJ. A review of psychological risk factors in back and neck pain. Spine (Phila Pa 1976). 2000 May 1;25(9):1148-56. doi: 10.1097/00007632-200005010-00017.

    PubMed 10788861
  • Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017 Feb 18;389(10070):736-747. doi: 10.1016/S0140-6736(16)30970-9. Epub 2016 Oct 11.

    PubMed 27745712
  • Zemedikun DT, Kigozi J, Wynne-Jones G, Guariglia A, Roberts T. Methodological considerations in the assessment of direct and indirect costs of back pain: A systematic scoping review. PLoS One. 2021 May 11;16(5):e0251406. doi: 10.1371/journal.pone.0251406. eCollection 2021.

    PubMed 33974661
  • Mociu SI, Ionescu EV, Uzun AB, Ciufu N, Ciota AE, Iliescu TE, Calatoiu I, Petcu LC, Iliescu MG. 4-Week Comparative Outcomes of Standard Physiotherapy, Balneotherapy Plus Physiotherapy and Dextrose Prolotherapy in Patients with Low Back Pain: A Non-Randomized Study. Medicina (Kaunas). 2026 Mar 25;62(4):623. doi: 10.3390/medicina62040623.

    PubMed 42075495

Questions about this trial

What is this clinical trial studying?

A study testing Prolotherapy, Balneotherapy plus Physiotherapy and Physiotherapy in people with Low Back Pain, run by Balnear and Rehabilitation Sanatorium Techirghiol at 1 site in Romania.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Romania. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain intensity (time frame: Baseline and follow-up assessments were conducted at 4 weeks after treatment completion). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07399145, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Feb 2026.

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