To investigate the effect of high-intensity laser acupuncture on fatigue, proprioception, back pain and Pain self-efficacy in patients with chronic nonspecific low back pain (CNLBP).

Chronic non-specific low back pain (CNSLBP) is a persistent back pain that affects people of all ages and significantly impacts individuals' functional activities. Fatigue and impaired proprioception are common complaints associated with CNSLBP, contributing to diminished physical performance and exacerbation of symptoms. While various treatment modalities exist, there is ongoing interest in exploring novel approaches to manage this condition effectively.Laser photobiomodulation (PBM) therapy is a noninvasive that stimulates cells, pain receptors, and the immune system and can cause analgesic effects. Recently, high-power lasers have been used for managing musculoskeletal dysfunction that allows for more energy deposition in deep tissues, resulting in both biological and thermal effects. High-power laser acupuncture (HPLA) has emerged as a promising intervention that combines the therapeutic effects of high-power laser therapy and the principles of acupuncture point stimulation on the body (acupoints) to induce physiological effect. However, there is limited evidence supporting this combined approach. For that, this study aims to investigate the effect of HPLA on fatigue, proprioception back pain and Pain self-efficacy in patients with CNSLBP. With this current randomized controlled trial, we seek to provide evidence-based insights into the potential effects of this combined approach on measurements of fatigue, proprioception, back pain and Pain self-efficacy.

Inclusion Criteria:

• 1. The patients had CNSLBP with age from 20 to 40 years from both genders.

  2. Patients diagnosis with chronic low back pain without underlying pathological causes.

  3. The patients with chronic nonspecific low back pain more than 3months. Minimum pain intensity of 30 mm on the visual analogue scale (VAS) for pain, which ranges from 0 to 100 mm.

  4. Patients with BMI ranges between 18.5:29.9 kg/m2.

  5. The study populations must be willing to participate in the study

Exclusion Criteria:

1. Neurological, infectious diseases and systemic illness such as rheumatologic diseases,systemic lupus erythematosus, diabetes mellitus type I or II.
2. Psychiatric/mental deficit.
3. Patients who had a previous surgical history (within 6 months) will also excluded
4. participation in other treatment within the previous 3 month.
5. Pregnancy.
6. History of spinal fracture, tumor, osteoporosis

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