Immediate Effects of Myofascial Techniques on Thoracolumbar Fascia Stiffness, Thickness, and Pain Intensity in Chronic Non-Specific Low Back Pain

Low back pain (LBP) is a prevalent health issue that has major consequences for quality of life and results in significant financial burden. Recent studies have suggested that fasciae, particularly the thoracolumbar fascia (TLF), may play a role in chronic pain.

Myofascial therapy (MFT) targeting fasciae aims to decrease tension in the myofascial tissues, increase function, and reduce pain. A study aimed to evaluate the immediate effect of a standardized MFT versus a simulated MFT on the stiffness of the TLF and lumbar erector spinae muscles using shear wave elastography, as well as the thickness of the TLF and pain intensity. The researchers hypothesized that the standardized MFT would lead to a decrease in TLF and erector spinae muscle stiffness, a decrease in the thickness of the posterior layer of the TLF, and an immediate/short-term decrease in pain intensity when compared with the simulated MFT.

The experimental study was carried out at a research center in Quebec, Canada. A total of 49 participants were recruited and randomly assigned to either an MFT group or a simulated MFT group. The participants underwent assessments of tissue stiffness and thickness, pain intensity, lumbar flexion range of motion, and physical activity level at various time points. A blinded evaluator conducted the post-treatment assessment (T1) comprising the sonoelastographic evaluation.

The study revealed no significant changes in tissue stiffness of the thoracolumbar fascia (TLF) but showed a decrease in lumbar erector spinae muscle stiffness after the application of the MFT.

The MFT group showed a significant decrease in left erector spinae muscle stiffness and left TLF thickness compared to the simulated group. In addition, there was a significant reduction in pain intensity in the MFT group compared to the simulated group. 

The study concluded that MFT caused an immediate decrease in erector spinae muscle stiffness, a decrease in thoracolumbar fascia thickness, and an increase in subcutaneous tissue thickness. The MFT group also experienced an immediate and short-term decrease in pain intensity. This study is one of the first to validate the effects of MFT using shear wave sonoelastography.