A Comparative Clinical Evaluation of Ultrasound-guided Acupotomy Combined with Extracorporeal Shock Wave Therapy for...

Nonspecific low back pain (NLBP) is a prevalent condition associated with pain and functional limitation. This study evaluated the therapeutic efficacy and procedural feasibility of ultrasound-guided acupotomy combined with extracorporeal shock wave therapy (ESWT) compared with monotherapy approaches for NLBP. A total of 90 patients with NLBP were randomly allocated to three groups (n = 30 each). In the acupotomy group, trigger points within the lumbar erector spinae muscles were identified by palpation and treated using acupotomy. In the shock wave group, ESWT was applied to painful areas using an energy density of 0.10-0.20 mJ/mm² at a frequency of 10 Hz. In the combined group, ESWT and acupotomy were performed sequentially under ultrasound guidance. Clinical outcomes were evaluated using the visual analog scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores before treatment and at a 2-month follow-up. Therapeutic efficacy was additionally assessed in accordance with the Traditional Chinese Medicine Syndrome Diagnosis and Efficacy Standard. Baseline scores were comparable among groups (p > 0.05). After treatment, the combined group demonstrated significantly lower VAS and ODI scores, higher JOA scores, and a higher overall effective rate (93.33%) compared with the monotherapy groups (p < 0.05). This study presents a structured protocol for combining ultrasound-guided acupotomy with ESWT for NLBP and demonstrates improved short-term clinical outcomes compared with monotherapy.