Hyaluronan (HA) has been recently identified as a key component of the densification of thoracolumbar fascia (TLF), a potential contributor to non-specific lower back pain (LBP) currently treated with manual therapy and systemic or local delivery of anti-inflammatory drugs. The aim of this study was to establish a novel animal model suitable for studying ultrasound-guided intrafascial injection prepared from HA with low and high Mw. Effects of these preparations on the profibrotic switch and mechanical properties of TLF were measured by qPCR and rheology, respectively, while their lubricating properties were evaluated by tribology. Rabbit proved to be a suitable model of TLF physiology due to its manageable size enabling both TLF extraction and in situ intrafascial injection. Surprisingly, the tribology showed that low Mw HA was a better lubricant than the high Mw HA. It was also better suited for intrafascial injection due to its lower injection force and ability to freely spread between TLF layers. No profibrotic effects of either HA preparation in the TLF were observed. The intrafascial application of HA with lower MW into the TLF appears to be a promising way how to increase the gliding of the fascial layers and target the myofascial LBP.

Biotribology Research Group Faculty of Mechanical Engineering Brno University of Technology 616 69 Brno Czech Republic

Contipro a s Dolní Dobrouč 401 561 02 Dolní Dobrouč Czech Republic

Department of Dentistry Charles University Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove 500 05 Hradec Kralové Czech Republic

DIPLOMA Hochschule 37242 Bad Sooden Allendorf Germany; Conservative and Rehabilitative Orthopedics Department of Sport and Health Sciences Technical University of Munich 80333 Munich Germany

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