Modulation of Brain Activity in Patients with Acute Non-Specific Low Back Pain by Wentong Guan Therapy: A Functional Near-Infrared Spectroscopy Study

Background: Wentong Guan Therapy (WTG) integrates techniques from Chinese massage, moxibustion, scraping, and cupping. Its analgesic mechanisms remain unclear. The brain functional network in patients with acute non-specific low back pain (ANSLBP) is impaired, and central nervous system regulation is one of the important mechanisms through which traditional Chinese medicine external therapies alleviate pain and functional impairment in ANSLBP. This study neurophysiologically evaluates WTG’s pain modulation effect on the cerebral cortex in acute non-specific low back pain (ANSLBP). Methods: Twelve ANSLBP patients received a single WTG session. Subjective pain (Visual Analogue Scale, VAS), pressure pain threshold (PPT) using a force-measuring glove, and cortical hemodynamic changes via functional near-infrared spectroscopy (fNIRS) were assessed pre- and post-treatment. False discovery rate (FDR) corrected multiple comparisons. Results: Post-treatment, VAS scores significantly decreased (4.75± 1.29 to 3.58± 1.17, p 0.05). Pre-treatment HbO 2 concentration in channel 17 (DLPFC) was significant (P FDR =0.042), but post-treatment, no channels showed significance. Channel 33 (Somatosensory Association Cortex, SAC) showed a significant HbO 2 change post-treatment (P FDR =0.038). ΔHbO 2 in SAC (CH33) negatively correlated with ΔPPT (P=0.045, r=− 0.587). Conclusion: WTG effectively alleviates ANSLBP. The SAC and DLPFC are involved in WTG’s neuromodulatory analgesic effects. Reduced ΔHbO 2 in the SAC may be a potential biomarker for WTG’s analgesia. Keywords: Wentong Guan therapy, acute non-specific low back pain, functional near-infrared spectroscopy, neuroactivity, somatosensory association cortex, dorsolateral prefrontal cortex