Musculoskeletal ultrasound-guided needle knife therapy in the treatment of refractory nonspecific low back pain: A single-blind, randomized controlled trial

BACKGROUND: This clinical study aimed to evaluate the Numerical Rating Scale (NRS), Oswestry disability index (ODI), and Japanese Orthopedic Association (JOA) scores at 2, 4, 6, and 12 weeks, and the thickness of the 4th lumbar multifidus under ultrasound at 6 and 12 weeks, using musculoskeletal ultrasound (MU)-guided needle-knife loosening therapy for treating refractory nonspecific low back pain (RNSLBP) compared to usual care, to demonstrate the clinical efficacy of needle knife therapy for RNSLBP. This study used a single-blind, randomized controlled design. METHODS: A total of 66 patients with RNSLBP who met the inclusion criteria were randomly divided into an observation group and a control group of 33 patients. The observation group underwent MU-guided needle knife release for RNSLBP, whereas the control group underwent low-frequency transcutaneous electrical nerve stimulation therapy, exercise therapy, and oral celecoxib capsules if necessary. RESULTS: No statistically significant differences were observed in the baseline data (sex, age, body mass index, disease duration, NRS score, ODI score, JOA score, and 4th lumbar multifidus muscle thickness) (P > .05) between the 2 groups, with both groups having flat baseline and comparable indices. After 2, 4, 6, and 12 weeks of treatment, NRS and ODI scores decreased, while JOA scores increased in both groups, with statistically significant differences both within and between the 2 groups. The observation group showed better results than did the control group. The difference in multifidus muscle thickness between the 2 groups was not statistically significant after the final treatment; however, at the 12-week follow-up, the observation group showed significantly greater multifidus muscle thickness than the control group, with a statistically significant difference. CONCLUSION: This study demonstrated that MU-guided needle knife release effectively treats RNSLBP by reducing pain, improving lumbar spine function, and increasing the multifidus muscle thickness. It is efficient, safe, has a shorter treatment period, and causes fewer adverse reactions.