Effect of SFMA-guided Qihuang Needling vs conventional acupuncture on paraspinal neuromuscular activity in lumbar disc herniation: A randomised controlled trial

BackgroundLumbar disc herniation (LDH) commonly causes chronic low back and leg pain. Qihuang Needling (QN) is a micro-invasive technique targeting myofascial dysfunction, but its effects on paraspinal neuromuscular activity have not been objectively quantified.ObjectiveTo determine whether SFMA-guided QN produces greater immediate improvement than conventional acupuncture (CA) in paraspinal neuromuscular activity.MethodsIn this single-centre, assessor- and statistician-blinded trial, 68 outpatients with LDH were allocated 1:1 to five daily sessions of SFMA-guided QN or CA. The primary endpoint was static multifidus AEMG, analysed by ANCOVA with baseline adjustment; pain and disability were exploratory endpoints.ResultsAll 68 participants completed the trial. Static multifidus AEMG increased more with QN than CA (adjusted difference 7.43 μV, 95% CI 2.74 to 12.12; P = 0.002). All seven secondary sEMG endpoints also improved more with QN after false-discovery-rate control. The Oswestry Disability Index difference was -17.17 points (95% CI -20.53 to -13.81); responder rates were 76.5% versus 35.3% (P = 0.001). No serious adverse events occurred.ConclusionsFive daily sessions of SFMA-guided QN produced greater immediate improvement in paraspinal neuromuscular activity than CA. Whether these differences persist, and which components account for them, cannot be determined from this trial.