Assessment Of Shear Wave Elastography Of Inner Heating Dry Needle Therapy On Chronic Nonspecific Low Back Pain

Objective: This study aims to evaluate the effects of using shear wave elastography in the assessment of chronic nonspecific low back pain. And of using shear wave elastography assessment of the inner heating dry needle for treatment of chronic nonspecific low back pain, and provide experimental basis for clinical application of inner heating dry needle therapy.Method: 1.The clinical diagnosis of chronic nonspecific low back pain in patients with 64 cases of low back pain group, the pain group were randomly divided into inner heating dry needle group and thermal magnetic group. Another 32 persons who had no symptoms of lumbago were selected as control group.2.Heating dry needle group : use of heating dry needle treatment, upper lumbar(L1-L3) and lumbosacral(L4-S1) two segment of treatment,interval of 4 days. Thermal magnetic group: treated with thermal magnetic therapy , once a day, a total of 6 times.3.Before the treatment, determination the Young's modulus of the erector spinae in the pain group and the control group, and record the patients visual analogue score (VAS) and Japanese Orthopaedic Association score (JOA).the VAS, JOA and Young's modulus in the pain group were measured twice (after 1 week of treatment and 2 month of treatment respectively ).4. Using SPSS 22.0 for data analysis , P < 0.05 for the difference was statistically significant.Results: 1.The Change of VAS : There is no significant difference between inner heating dry needle group and thermal magnetic group before treatment(P>0.05).VAS of both group were lower than before treatment after 1 week of treatment (P<0.01); The VAS of inner heating dry needle group was lower than that of thermal magnetic group after 2 months of treatment (P<0.01).2.The change of JOA: No significant difference of JOA (P > 0.05) between inner heating dry needle group and thermal magnetic group before treatment .After 1 week of treatment, JOA of both groups were higher than before(P < 0.01). JOA of the inner heating dry needle group was further increased after 2 months of treatment (P< 0.01),while the thermal magnetic group JOA score was no significant change (P > 0.05). 1 week and 2 months after the treatment inner heating dry needle group JOA was higher than thermal magnetic group (P < 0.01).3.The change of the hardness value (Young's modulus) of lumbar erector spinae:3.1 There is no significant difference of Yang's modulus of bilateral lumbar erector spinae in one person neither pain group nor control group(P > 0.05).3.2 Both the young's modulus value of inner heating dry needle group and thermal magnetic group are higher than that of the control group (P < 0.01).3.3 There was a positive correlation between Young's modulus and VAS score (P <0.05), and there was no significant correlation with JOA score (P > 0.05).3.4 Before treatment inner heating dry needle group and thermal magnetic group Young's modulus had no significant difference (P > 0.05). All the two group 1 weeks after treatment, Young's modulus were lower than before treatment (P < 0.01). The inner heating dry needle group Young's modulus was further reduced after 2 months of treatment (P< 0.01), while the thermal magnetic group Young's modulus was no significant change than 1 weeks after treatment (P > 0.05). Young's modulus of inner heating dry needle group was lower than that of thermal magnetic group (P <0.01, after 1 week of treatment and 2 moths of treatment).Conclusion: SWE can accurately measure the hardness of erector spinae of the patients with CNSLBP,and reflect patienrts' muscle tension. Inner heating dry needle therapy can reduce the muscle hardness in patients with chronic nonspecific low back pain patients,and improve their muscle tension, and relieve pain symptoms significantly , and improve lumbar function.