High-Intensity Laser Therapy Versus Transforaminal Epidural Steroid Injection in Chronic Lumbar Disc Herniation-Related Low Back and Radicular Pain

Inclusion Criteria: * Age between 18 and 65 years * Diagnosis of lumbar disc herniation confirmed by clinical examination and lumbar magnetic resonance imaging * Chronic axial low back pain and radicular pain related to lumbar disc herniation * Low back and/or radicular pain lasting longer than 3 months * Resting low back and/or radicular pain intensity of ≥5 on a 0-10 visual analog scale * Willingness to participate in the study and provide written informed consent Exclusion Criteria: * Pregnancy or suspected pregnancy * Presence of a cardiac pacemaker * History of epilepsy * Active or previous malignancy * History of spinal surgery * Uncontrolled systemic or psychiatric disease * Cauda equina syndrome or progressive neurological deficit * Peripheral neuropathy, including diabetic or alcohol-related neuropathy * Neurodegenerative disease * Acute trauma * Active systemic infection * Local infection or skin disease at the injection site or treatment area * Body mass index greater than 40 kg/m² * Bleeding disorder that contraindicates treatment * Spinal stenosis, spondylolysis, or spondylolisthesis * Neurogenic bladder or bowel syndrome * Rheumatologic disease * Arterial vascular disease or vascular claudication * Receipt of other physical therapy modalities within the last 3 months * Receipt of spinal injection therapy within the last 3 months * History of allergy to injection agents