Despite the widespread use of therapeutic ultrasound as one of the most popular and commonly used modal- ities in the field of physiotherapy for LBP patients, there is still limited evidence of its effectiveness. Only a few RCTs have investigated the effect of ultrasound in treat- ing patients with chronic LBP; often with varying meth- odology qualities and very small sample sizes, and have not been able to provide evidence regarding its usefulness.
The RCT we have described will evaluate the effective- ness of therapeutic ultrasound in addition to exercise therapy in patients with chronic LBP. The advantages of this study would be comparing the ultrasound with pla- cebo ultrasound, which would clarify the value of adding ultrasound to a semi-supervised exercise program. Lim- ited possibilities for double blinding can be a potential limitation to this study. Meanwhile we will evaluate potential bias by asking the patients whether they think they received real or sham ultrasound on the last treat- ment session. Recruiting a sufficient number of patients will be one of the most challenging elements of this study since it will be conducted without substantial funding.