MyofascialReleaseforChronicLowBackPain:ASystematicReviewandMeta-Analysis

Chronic low back pain (CLBP) affects millions of elderly individuals worldwide and represents one of the most common musculoskeletal conditions. Traditional treatments like non-steroidal anti-inflammatory drugs can cause significant side effects with long-term use, while surgical interventions often result in complications or failed back surgery syndrome. Myofascial release, a manual therapy technique that applies pressure to muscles and fascia to restore damaged soft tissue function, has emerged as a potential treatment option. However, its effectiveness for CLBP remains controversial, with studies showing mixed results.

Researchers conducted a comprehensive systematic review and meta-analysis by searching four major medical databases (PubMed, Cochrane Library, EMBASE, and Web of Science) through April 2021. They identified 8 randomized controlled trials involving 375 patients with chronic low back pain. The studies compared myofascial release against various control interventions including sham treatment, exercise therapy, spinal manipulation, and physiotherapy programs. The researchers analyzed multiple outcomes including pain levels, physical function, quality of life, balance function, pain pressure threshold, trunk mobility, and mental health.

They used standardized statistical methods to combine results and assess the overall effectiveness of myofascial release.

The meta-analysis revealed that myofascial release significantly improved two key outcomes in patients with chronic low back pain. Pain levels showed moderate improvement with a standardized mean difference of -0.37, and physical function demonstrated similar benefits with a standardized mean difference of -0.43. Subgroup analysis revealed that myofascial release was most effective when compared to sham treatments, showing substantial pain reduction and functional improvement. However, when combined with other interventions like exercise or spinal manipulation, the additional benefits were less clear.

The treatment did not show significant effects on quality of life, balance function, pain pressure threshold, trunk mobility, or mental health measures. Only one study reported adverse events, noting temporary pain increases in some patients during the first week of treatment.

This analysis provides moderate-quality evidence that myofascial release can be an effective treatment for reducing pain and improving physical function in people with chronic low back pain. The technique appears most beneficial when used as a primary intervention rather than as an add-on to other treatments. For patients seeking non-pharmacological alternatives to manage their chronic back pain, myofascial release represents a reasonable option with minimal risk of adverse effects. However, patients should not expect improvements in quality of life, balance, or mental health from myofascial release alone.

The limited number and quality of studies means these conclusions are preliminary, and more high-quality research is needed to fully establish the role of myofascial release in chronic low back pain management.