Effect of Ultrasound‐Guided Hydrorelease of the Multifidus Muscle on Acute Low Back Pain

Abstract

Objectives To examine improvement in acute low back pain (LBP) using ultrasound‐guided hydrorelease of the multifidus muscle. Methods This prognostic cohort study was conducted in a private clinic on samples of 75 patients with acute LBP diagnosed based on physical and imaging findings. Hydrorelease of the multifidus muscle was performed at the L4/5 level. The LBP visual analog scale (VAS) scores (cm) before and 5 minutes after hydrorelease were statistically evaluated. We defined improvement rate (%) as {LBP VAS scores (cm) immediately before hydrorelease – LBP VAS scores (cm) 5 minutes after hydrorelease} × 100 / LBP VAS scores (cm) immediately before hydrorelease and examined the correlation of the Heckmatt score and average age with the improvement rate. Results LBP VAS scores (cm) before and 5 minutes after hydrorelease were 7.19 ± 1.01 (mean ± SD) and 2.85 ± 1.25, respectively (p < 0.05). No significant correlations were noted between the LBP improvement rate and the Heckmatt score or age. There were no gender variations in the improvement rate. Conclusions Ultrasound‐guided hydrorelease of the multifidus muscle led to considerable LBP VAS score improvement at the outpatient level. The improvement rate showed no correlations with the Heckmatt score or age, and there were no significant gender variations in the improvement rate. Therefore, fatty degeneration of muscles and change in muscle echogenicity due to age and gender may not be associated with muscular LBP. These findings suggest that multifidus muscle hydrorelease could be useful in the diagnosis and treatment of acute LBP.

Video Evidence of Tissue Sliding Improvement by Ultrasound-Guided Hydrorelease on Scars After Arthroscopic Knee Surgery: A Case Report

“…The patient had no serious adverse events requiring specific treatment. Furthermore, no serious adverse events have been reported in previous studies [6,7,11]. Finally, ultrasound-guided hydrorelease can be presented on videos, which can aid in informing the patient before obtaining the patient's consent for the procedure.…”

“…We injected saline mixed with lidocaine and prednisolone because the patient felt severe pain. In previous studies, saline only [6,7], saline mixed with 0.5% mepivacaine hydrochloride [11], and bicarbonate Ringer's solution [11] have been used. In a comparison of the analgesic effects of injectable agents, saline alone has been reported to be more analgesic than local anesthesia.…”

“…Ultrasound-guided hydrorelease has been performed for lower back pain [6] and postoperative scar tissue [7]. Machida et al consider ultrasound confirmation of improved tissue sliding as the key to the success of this procedure regarding the treatment of scar tissue after arthroscopic surgery.…”

A New Procedure for Ultrasound-Guided Hydrorelease for the Scarring After Arthroscopic Knee Surgery

“…Ultrasound-guided hydrorelease is often performed for myofascial pain syndrome, focusing on the interfascia between the muscles [ 20 ]. To the best of our knowledge, no study has applied this technique to postoperative scar tissue and/or IPFP.…”

Effectiveness of ultrasound-guided fascia hydrorelease on the coracohumeral ligament in patients with global limitation of the shoulder range of motion

“…Ultrasound-guided fascia hydrorelease (US-FHR) has become popular as a therapeutic options for (myo)fascial pain, especially in Japan 15 . Some reports have shown the effectiveness of US-FHR in various clinical conditions, such as myofascial pain syndrome on the shoulder 16 , acute low back pain 17 and pain from scarring after arthroscopic knee surgery 18 . US-FHR is an injection technique for the release of a "stacking" fascia that can be visualized as hyperechoic strip-shaped lesions on ultrasound images, akin to peeling off thin stacking papers.…”