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FOTO Rehab Outcomes Blog

Effects of Myofascial Release for Patients with Nonspecific Chronic Low Back Pain

This conclusion needs to be stated more strongly than it is.

When it comes to outcomes, a result will have meaning to the patient if the difference in scores falls outside of the minimal clinically important difference of the tool. Without reading the full text and seeing the actual scores and the data, it appears (based on the language in the conclusion) that myofasical release is no different than sham. Neither had clinical relevancy from the patient's perspective.

Below you will find a quick view of the abstract. 


Effects of Myofascial Release in Nonspecific Chronic Low Back Pain: A Randomized Clinical Trial.




Double-blind, randomized parallel sham-controlled trial with concealed allocation and intention-to treat analysis.


To investigate the effects of an isolate myofascial release (MFR) protocol on pain, disability, and fear-avoidance beliefs in patients with chronic low back pain (CLBP).


MFR is a form of manual medicine widely used by physiotherapists in the management of different musculoskeletal pathologies. Up to this moment, no previous studies have reported the effects of an isolated MFR treatment in patients with CLBP.


Fifty-four participants, with nonspecific CLBP, were randomized to MFR group (n = 27) receiving four sessions of myofascial treatment, each lasting 40 minutes, and to control group (n = 27) receiving a sham MFR. Variables studied were pain measured by means Short Form McGill Pain Questionnaire (SF-MPQ) and visual analog scale (VAS), disability measured with Roland Morris Questionnaire, and fear-avoidance beliefs measured with Fear-Avoidance Beliefs Questionnaire.


Subjects receiving MFR displayed significant improvements in pain (SF-MPQ) (mean difference -7.8; 95% confidence interval [CI]: -14.5 to -1.1, P = 0.023) and sensory SF-MPQ subscale (mean difference -6.1; 95% CI: -10.8 to -1.5, P = 0.011) compared to the sham group, but no differences were found in VAS between groups. Disability and the Fear-Avoidance Beliefs Questionnaire score also displayed a significant decrease in the MFR group (P < 0.05) as compared to sham MFR.


MFR therapy produced a significant improvement in both pain and disability. Because the minimal clinically important differences in pain and disability are, however, included in the 95% CI, we cannot know whether this improvement is clinically relevant.

2017 May 1;42(9):627-634. doi: 10.1097/BRS.0000000000001897.