Trial reportEuropean radiology experimental2026
Quantitative ultrasound evaluation of the thoracolumbar fascia after manual and acupuncture therapies: an exploratory mechanistic randomized controlled trial with a sequential within-subject phase.
Trial report in European radiology experimental, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04843800 (Imaging Pain! Ultrasound-based Palpation and Visualization for Diagnosing Chronic Low Back Pain), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Imaging Pain! Ultrasound-based Palpation and Visualization for Diagnosing Chronic Low Back Pain
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11 authors.
Funding
Abstract
objectiveThoracolumbar fascia (TLF) alterations may contribute to nonspecific low back pain (NSLBP). We evaluated the effects of acupuncture, chiropractic care, and massage on TLF biomechanics, microstructure, and clinical outcomes in NSLBP. MATERIALS AND
methodsIn this exploratory mechanistic hybrid trial, sixty participants (median age: 47 years [interquartile range 39-63]; 63% women) were randomized (1:1:1) to acupuncture, chiropractic, or a 3-week waitlist control, providing between-group comparisons. After the waitlist, control participants received massage therapy, enabling a sequential within-subject evaluation. Pre- and post-intervention assessments included TLF shear strain (ShS)-cumulated (C|ShS|
resultsIn the randomized comparison, C|ShS|
conclusionChiropractic and massage, unlike acupuncture, elicited detectable biomechanical changes, while chiropractic also enhanced disability outcomes. HKD detected no microstructural changes.
trial registrationClinicaltrials.gov, NCT04843800. Registered April 14, 2021 ( https://clinicaltrials.gov/study/NCT04843800 ). RELEVANCE STATEMENT: This study shows that ultrasound-derived shear strain captures the short-term mechanical responses of the thoracolumbar fascia to chiropractic care or massage therapy in participants with chronic nonspecific low back pain, supporting the potential role of quantitative fascial imaging biomarkers for mechanistic assessment and treatment monitoring of this prevalent, debilitating disorder. KEY POINTS: Recent research suggests that altered microstructure and biomechanics of the thoracolumbar fascia may contribute to nonspecific low back pain. In this randomized trial, chiropractic care, but not acupuncture, reduced thoracolumbar shear strain, while controls showed increased strain. In the within-subject sequential analysis, thoracolumbar shear strain increased during the waitlist phase and decreased after massage therapy. No microstructural changes were detected over 3 weeks, potentially reflecting biological constraints and/or limitations in measurement sensitivity. Small sample size and low baseline disability likely limited the trial's power to detect significant effects on clinical outcomes.
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