Effectiveness and mechanism of moxibustion in treating chronic non-specific low back pain: study protocol for a multicenter randomized controlled trial.

Researchers in China are conducting a large study to test whether moxibustion—a traditional Chinese therapy that uses burning herbs to warm specific points on the body—can effectively treat chronic non-specific low back pain. This type of back pain is the most common kind seen in clinics, has no clear cause, and often keeps coming back, significantly affecting people's daily lives. The study will involve 150 patients across three major hospitals in China. Half will receive real moxibustion treatment, while the other half will receive a fake (sham) treatment for comparison. Everyone will be treated at the same acupuncture points on their lower back, three times per week for eight weeks, with each session lasting 30 minutes. Researchers will track pain levels, disability, quality of life, and fear of movement over 16 weeks total. What makes this study particularly interesting is that researchers will also use advanced brain imaging technology called functional near-infrared spectroscopy (fNIRS) to see how moxibustion might change brain activity in pain-processing areas. This could help explain how moxibustion actually works to reduce pain. While moxibustion is commonly used in China for chronic pain with good results, there haven't been enough high-quality studies to convince the global medical community of its effectiveness. This research aims to provide stronger evidence that could support wider use of moxibustion for chronic back pain worldwide. If you're considering moxibustion treatment, it's important to seek care from a qualified, licensed practitioner trained in traditional Chinese medicine.

This multicenter randomized controlled trial will evaluate moxibustion efficacy for chronic non-specific low back pain (CNLBP) across three Chinese tertiary hospitals. The study will randomize 150 CNLBP patients 1:1 to moxibustion versus sham moxibustion at bilateral BL23 (Shenshu), GV3 (Yaoyangguan), and GV8 (Jinsuo). Treatment consists of 30-minute sessions three times weekly for eight weeks, followed by an eight-week follow-up period. The primary outcome is change in Numerical Rating Scale (NRS) scores from baseline to week eight. Secondary measures include Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire (FABQ), SF-36, Global Perceived Effect (GPE), and functional near-infrared spectroscopy (fNIRS) to assess cortical activation patterns in pain-related brain regions. Assessments occur at baseline, week four, week eight, and week sixteen. This protocol addresses the current evidence gap for moxibustion in CNLBP management and incorporates neuroimaging to elucidate potential mechanisms of action, which may strengthen clinical rationale and support broader integration into pain management protocols.