Modulation of Brain Activity in Patients with Acute Non-Specific Low Back Pain by Wentong Guan Therapy: A Functional Near-Infrared Spectroscopy Study.

BACKGROUND

Wentong Guan Therapy (WTG) integrates techniques from Chinese massage, moxibustion, scraping, and cupping. Its analgesic mechanisms remain unclear. The brain functional network in patients with acute non-specific low back pain (ANSLBP) is impaired, and central nervous system regulation is one of the important mechanisms through which traditional Chinese medicine external therapies alleviate pain and functional impairment in ANSLBP. This study neurophysiologically evaluates WTG's pain modulation effect on the cerebral cortex in acute non-specific low back pain (ANSLBP).

METHODS

Twelve ANSLBP patients received a single WTG session. Subjective pain (Visual Analogue Scale, VAS), pressure pain threshold (PPT) using a force-measuring glove, and cortical hemodynamic changes via functional near-infrared spectroscopy (fNIRS) were assessed pre- and post-treatment. False discovery rate (FDR) corrected multiple comparisons.

RESULTS

Post-treatment, VAS scores significantly decreased (4.75±1.29 to 3.58±1.17, p<0.001) and PPT increased (77.29±39.83N to 94.58±39.79N, p<0.001). No significant brain network differences were found (PFDR>0.05). Pre-treatment HbO2 concentration in channel 17 (DLPFC) was significant (PFDR=0.042), but post-treatment, no channels showed significance. Channel 33 (Somatosensory Association Cortex, SAC) showed a significant HbO2 change post-treatment (PFDR=0.038). ΔHbO2 in SAC (CH33) negatively correlated with ΔPPT (P=0.045, r=-0.587).

CONCLUSION

WTG effectively alleviates ANSLBP. The SAC and DLPFC are involved in WTG's neuromodulatory analgesic effects. Reduced ΔHbO2 in the SAC may be a potential biomarker for WTG's analgesia.