The effects of myofascial release on chronic non-specific low back pain : a methodological narrative review

Details

Supervisors

FIZAINE Stéphane ; SERCU Paul

Faculty

Faculté des sciences de la motricité

Degree label

Master [60] en kinésithérapie et réadaptation

Abstract

Objectives: The first objective of this literature review was to summarize the results of all randomized controlled trials who have studied the effects of myofascial release (MFR) on chronic non-specific low back pain (CNSLBP) to see whether or not they have a beneficial effect and check out their level of scientific evidence. The secondary objective was to see if these effects were significant and if they were sustained over time, in order to demonstrate the value of targeting fascia to treat CNSLBP and thus consider clinical application. The integration of fascias in the pathophysiology of chronic non-specific low back pain, as well as the proposal of different treatments that could contribute to the management of this pathology by a systemic approach, were also indirect objectives of this work. Methods: A literature research through 4 electronic databases was conducted. Only randomized controlled studies were included, and study selection and data extraction were done using PICOS’s criteria. The methodological quality of these studies was assessed using the PEDro and the Downs & Black rating scales. Results: Only 16 studies met the eligibility criteria. For the analysis of their results, because of their wide heterogeneity, these studies were separated into two groups of 8 studies to avoid any potential bias. The results show a significant decrease in the level of perceived pain and disability after MFR treatment compared to a control group. MFR also induces a significant increase in lumbar flexibility, immediate and maintained over time, whether the manipulation is performed on the lumbar region or on another site along the posterior chain. Conclusion: MFR techniques appear to be effective manual techniques to improve pain and disability perception in people with non-specific LBP, as well as lumbar range of motion and should be clinically integrated into a multi-disciplinary treatment. These results justify the need to take fascia into account for the treatment of CNSLBP and suggest that manipulations should be performed not only on the part of the body where the symptoms manifest themselves, in order to treat the problem and not just the symptoms.