Clinical Research Directory

Inclusion Criteria: * Low back pain for ≥12 weeks * Pain intensity VAS ≥3 cm at Visit 1 (baseline) * Age 18-65 years * Able and willing to provide written informed consent * Able and willing to attend treatment sessions at Pusat Sejahtera, Universiti Sains Malaysia and complete the 3-month follow-up phone assessment Exclusion Criteria: * Pregnant or planning pregnancy; females unwilling to use pregnancy prevention during the study * Current or past history of trauma or cancer * Prior spine surgery * Severe infection (e.g., tuberculosis, pyogenic abscess) * Fever ≥38°C lasting ≥48 hours at recruitment * Cauda equina syndrome * Significant spinal cord compression with serious disability (per medical history) * Osteoporosis requiring pharmacologic treatment * Severe dementia, cognitive impairment, other major cerebral disease, or severe psychiatric/psychological disorder * Significant renal or hepatic disease * BMI ≥34.9 kg/m² * History of recreational drug abuse * Use of systemic steroids within the past 6 months * Use of any analgesics (including paracetamol) within the past 30 days * Acupuncture treatment within the past 30 days