Efficacy Of Via Silver Needle Thermo-conduction Therapy Thoracic Vertebra Facet In The Treatment Of Chronic Thoracic Dorsal Pain

Research background:The incidence of chest-back pain is about 15%?22%,according to the improved diagnostic criteria of International Association for the study of pain(IASP),chest-back paincaused by thoracic facet joint lesions accounts for about 34%?48%.The most easily recognized degenerative changein degenerative spinal diseases is disc degeneration.In clinical work,the intervertebral disc degeneration and protrusion has been paid more attention,however,the problems caused by facet jointsdegeneration are often ignored.For a long time,because of its anatomical structure is very complex and hidden,and the requirement of image observation technologyis high,the diseases caused by facet jointdegenerationare often missed or misdiagnosed.In fact,the degeneration of the intervertebral disc is accompanied by the degeneration of facet joints,including the destruction of articular surface,the hyperplasia of the articular process,the calcification of the joint capsule and the hypertrophy of the ligamentum flavum,besides,facet joints constitutes a bilateral nerve root canal wall,pathological changes of facet joint degeneration process can cause nerve channel occupying oppression,lead to nerve root irritation symptoms,sensory dysfunction and root paralysis.Compared with intervertebral disc degeneration,the facet joint degenerationis more general and harmful,so we should improve the understanding of it.At present,it is widely believed that the pathological changes of facet joint degeneration includes the following three stage:The early degenerationis mainly manifested as metabolic disorderof facet joint cartilage surface,cartilage thinning and joint laxity At the middle stage;on the basis of the previous,facet hypertrophy,joint capsule and ligaments began to fibrosis;The late degeneration is mainly manifested as facet joint hyperplasia,facet by sagittal,coronal oriented transitional small joint cohesion,articular cartilage surface completely destroyed,narrowing of joint space,joint capsule fibrosis or evenossification.These degenerative changes in the thoracic spine may cause symptoms such as chest-back pain,chest tightness,banding,difficulty breathing and even abdominal distension.Chronic chest-back pain is mainly treated with non-surgical therapy.Non-surgical therapymainly include drugs,thermal silver needle therapy,nerve block,acupuncture and rehabilitation and so on.The majority of acute chest-back pain patients can relieve painwith drug,rehabilitation therapy,only a small number of acute chest-back pain patients fail to regular treatment and turn to be chronic pain.This kind of painoften need further treatments,such as silver needle therapy,nerve block and otherinvasive therapy.Objectives:To explore the efficacy of via silver needle thermo-conduction therapy thoracic vertebra facet in the treatment of chronic thoracic dorsal pain caused by thoracic vertebra facet joint disease.Methods:One hundred and ten patients with chronic thoracic dorsal pain caused by thoracic vertebra facet joint disease were randomized into silver needle group and control group according to the time sequence of seeing the doctor.The patients in silver needle group adopted silver needle thermo-conduction therapy via thoracic vertebra facet,The patients in control group only used drug therapy.The patients were followed up at 2 weeks,2 months and 4 months after treatment.Degree of pain were evaluated with visual analogue scales(VAS),and the influence degree of pain on patients' work and life were recorded.Results:VAS and the degree of influence on the work and life in the silver needle group is less than those in the control group(P<0.05).Conclusions:Silver needle thermo-conduction therapy via thoracic vertebra facet is effective in the treatment of chronic thoracic dorsal pain caused by thoracic vertebra facet joint disease.