{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:45:25Z","timestamp":1785843925636,"version":"3.56.0"},"reference-count":67,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009391","name":"Deanship of Research and Graduate Studies, University of Tabuk, Saudi Arabia","doi-asserted-by":"publisher","award":["S-1443-0200"],"award-info":[{"award-number":["S-1443-0200"]}],"id":[{"id":"10.13039\/100009391","id-type":"DOI","asserted-by":"publisher"}]},{"award":["S-1443-0200"],"award-info":[{"award-number":["S-1443-0200"]}],"id":[{"id":"https:\/\/ror.org\/04yej8x59","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Chronic low back pain (CLBP) is a leading cause of global disability, linked to elevated IL-6 and vitamin D deficiency or insufficiency. While interferential current (IFC) therapy and exercise therapy are established treatments, their combined effect with vitamin D supplementation on inflammatory biomarkers, pain, and functional disability remains underexplored. Objective: The aim of this study was to evaluate the combined effects of physiotherapy and vitamin D supplementation on pain, disability, IL-6 expression, and vitamin D levels in CLBP patients. Methods: This two-arm, parallel-group, randomized controlled trial enrolled 60 CLBP patients, randomized into Group A (physiotherapy alone: IFC therapy and exercise therapy; n = 30) or Group B (physiotherapy plus vitamin D supplementation; n = 30). Outcomes included pain intensity (11-point Numeric Pain Rating Scale (NPRS)), disability (Arabic Oswestry Disability Index (ODI), 0\u2013100%), and serum IL-6 and 25-hydroxyvitamin D (both by ELISA; pg\/mL and ng\/mL, respectively), which were assessed at baseline and 6 weeks. All 60 participants enrolled had laboratory-confirmed vitamin D deficiency or insufficiency (serum 25(OH)D &lt; 20 ng\/mL) at screening. Independent samples t-tests compared continuous baseline characteristics and between-group differences in 6-week change scores; paired t-tests assessed within-group change from baseline to 6 weeks; the chi-square test compared the categorical variable of gender (\u03b1 = 0.05). Results: Both groups showed significant improvements in NPRS and ODI at six weeks (p &lt; 0.001). Group B demonstrated significant reductions in NPRS (\u22123.01 vs. \u22121.71) and ODI (21.83% vs. 16.33%). IL-6 decreased significantly only in Group B (18.24 pg\/mL, p &lt; 0.001), with no significant change in Group A (25.96 pg\/mL, p = 0.626). Vitamin D levels increased significantly in Group B (31.68 ng\/mL, p &lt; 0.001) compared with Group A (19.68 ng\/mL, p = 0.115), a between-group difference that was also statistically significant. Conclusions: Combining physiotherapy with vitamin D supplementation improves outcomes in the management of CLBP. This approach effectively reduces pain, functional disability, inflammation, and vitamin D deficiency or insufficiency, offering a comprehensive, evidence-based treatment strategy.<\/jats:p>","DOI":"10.3390\/life16081288","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T10:38:08Z","timestamp":1785839888000},"page":"1288","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Effects of Physiotherapy and Vitamin D Supplementation on Pain, Disability, and IL-6 Expression in Chronic Low Back Pain: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2496-2226","authenticated-orcid":false,"given":"Abdulaziz A.","family":"Albalwi","sequence":"first","affiliation":[{"name":"Department of Health Rehabilitation Sciences, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5859-7258","authenticated-orcid":false,"given":"Hamad S.","family":"Al Amer","sequence":"additional","affiliation":[{"name":"Department of Health Rehabilitation Sciences, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashid","family":"Mir","sequence":"additional","affiliation":[{"name":"Prince Fahd Bin Sultan Chair for Biomedical Research, University of Tabuk, Tabuk 71491, Saudi Arabia"},{"name":"Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5003-7501","authenticated-orcid":false,"given":"Shahul Hameed Pakkir","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Health Rehabilitation Sciences, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamsheed","family":"Javid","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2068-3075","authenticated-orcid":false,"given":"Mohammad Muzaffar","family":"Mir","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, College of Medicine, University of Bisha, Bisha 61922, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waad","family":"Alamri","sequence":"additional","affiliation":[{"name":"Prince Fahd Bin Sultan Chair for Biomedical Research, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2374-7716","authenticated-orcid":false,"given":"Yousef M.","family":"Alshehre","sequence":"additional","affiliation":[{"name":"Department of Health Rehabilitation Sciences, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3086-2640","authenticated-orcid":false,"given":"Ahmad A.","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Department of Health Rehabilitation Sciences, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1002\/art.34347","article-title":"A systematic review of the global prevalence of low back pain","volume":"64","author":"Hoy","year":"2012","journal-title":"Arthritis Rheum."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2356","DOI":"10.1016\/S0140-6736(18)30480-X","article-title":"Lancet Low Back Pain Series Working Group. 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