Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 1;11(1):89.
doi: 10.1186/s40814-025-01673-x.

Precision targeting in acupuncture: a pilot and feasibility study protocol of ultrasound-guided approach for non-specific low back pain

Zihan Liu #  1 , Tianying Chang #  2 , Jili Fu  3 , Hui Chi  3 , Xiaodan Wang  1 , Lisha Wang  1 , Wenqi Cui  1 , Yingzi Cui  2 , Zhibin Cong  4
Affiliations

Precision targeting in acupuncture: a pilot and feasibility study protocol of ultrasound-guided approach for non-specific low back pain

Zihan Liu et al. Pilot Feasibility Stud. .

Abstract

Introduction: Non-specific low back pain (NLBP) is increasingly prevalent in the world due to changes in lifestyle and work habits. It is found that the symptom is usually associated with damage in the thoracolumbar fascia (TLF) and its surrounding muscles. This paper introduces a pioneering approach for treating NLBP, using the heterogeneous echo zones on ultrasound images as needling targets, presenting a novel treatment protocol.

Methods: An open randomized controlled trial is designed and conducted, in which 48 patients with NLBP will be randomly allocated at a ratio of one to one to an ultrasound-guided acupuncture (UGA) group and a regular acupuncture treatment (RA) group. The trial involves a 3-week treatment along with a follow-up for 3 weeks. Its primary purpose is to evaluate the feasibility and safety of ultrasound-guided acupuncture in the TLF and its adjacent muscles as a treatment method for NLBP. As its secondary objective, the treatment effectiveness will be assessed by observing the changes in the patient's pain level and low back dysfunction before and after treatment. The ultrasound-related parameters and adverse events will also be collected.

Discussion: It is a novel therapeutic approach to treat NLBP with ultrasound-guided acupuncture performed in the TLF and its adjacent muscles, which is characterized by integrating acupuncture with ultrasound. This study is a single-site, open, randomized controlled study designed and conducted to evaluate the effectiveness of the method. If this strategy turns out to be safe and feasible, future in-depth and extensive research will be planned.

Trial registration: International Traditional Medicine Clinical Trial Registry, ITMCTR2025000046. Registered on January 9, 2025. http://itmctr.ccebtcm.org.cn/.

Keywords: Non-specific low back pain; Thoracolumbar fascia; Ultrasound-guided acupuncture.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study has been approved by the Ethics Committee of the Affiliated Hospital of Changchun University of Chinese Medicine (No.CCZYFYKYLL2024审字-240). All participants will sign an informed consent form before being enrolled in the study. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the trial procedure, with UGA for ultrasound-guided acupuncture, and RA for regular acupuncture
Fig. 2
Fig. 2
Physician using ultrasound-guided acupuncture to treat a patient with NLBP
Fig. 3
Fig. 3
Schematic diagram of normal myofilament alignment
Fig. 4
Fig. 4
Sonogram with normal myofilament alignment
Fig. 5
Fig. 5
Sonogram of a heterogeneous echo zone within the muscle, with arrows showing the zone of heterogeneous echogenicity within the muscle
Fig. 6
Fig. 6
Schematic diagram of heterogeneous echo zones within the muscle
Fig. 7
Fig. 7
Position relationship between the ultrasound probe and the needle: in-plane needle insertion (a) and out-of-plane needle insertion (b), with the arrow showing the tip of the needle
Fig. 8
Fig. 8
Physician holding a probe in one hand and a needle in the other, and the ultrasound-guided needle is inserted into the heterogeneous echo zone
Fig. 9
Fig. 9
Schematic diagram of needling in heterogeneous echo zones
Fig. 10
Fig. 10
Sonogram of needling in heterogeneous echo zones, with arrows showing the tips of the needles
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. Lancet (London, England). 2012;379(9814):482–91. - PubMed
    1. Chiarotto A, Solomon CG, Koes BW. Nonspecific low back pain. N Engl J Med. 2022;386(18):1732–40. - PubMed
    1. Vos T, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulkader RS, Abdulle AM, Abebo TA, Abera SF, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2017;390(10100):1211–59. - PMC - PubMed
    1. Collaborators GBDLBP: Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol 2023, 5(6):e316-e329. - PMC - PubMed
    1. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, Hoy D, Karppinen J, Pransky G, Sieper J, et al. What low back pain is and why we need to pay attention. Lancet (London, England). 2018;391(10137):2356–67. - PubMed

LinkOut - more resources