Effectiveness of Myofascial Release Combined With Capacitive-Resistive Therapy in Patients With Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial

TL;DR

This study tested combining myofascial release and TECAR therapy for chronic low back pain but found no major benefits over using either treatment alone.

Contribution

The study is the first to compare combined myofascial release and TECAR therapy with individual treatments in a randomized controlled trial for chronic low back pain.

Findings

All treatments improved pain and disability, but the combination did not show significantly better results.

The combined therapy improved pressure pain threshold in the right quadratus lumborum muscle more than TECAR alone.

Secondary outcomes like TLF thickness and psychometric measures improved over time but not between groups.

Abstract

Background: Chronic nonspecific low back pain (CNLBP) is often associated with impaired mobility, functional limitations, and psychological distress. While myofascial release (MFR) and capacitive-resistive therapy (TECAR) have individually shown potential benefits, evidence regarding their combined application is limited.

Methods: This assessor-blinded, three-arm randomized controlled trial included 67 patients with CNLBP. Participants were assigned to MFR alone, resistive-mode TECAR (R-TECAR) alone, or MFR plus R-TECAR. Interventions were administered twice weekly for 4 weeks, with each session lasting 20 min. Primary outcomes included the Numeric Pain Rating Scale (NPRS) and the Roland–Morris Disability Questionnaire (RMDQ), assessed at the baseline, 4 weeks, and one-and-a-half-month follow-up. Secondary outcomes encompassed thoracolumbar fascia (TLF) thickness, pressure pain threshold (PPT), trunk mobility, quality of life, anxiety, and depression. Intention-to-treat analyses were performed.

Results: All interventions yielded significant improvements in pain and disability over time, although the combined MFR + R-TECAR therapy did not achieve statistically significant additional benefits compared with single therapies. Notably, a significant interaction effect emerged for PPT in the right quadratus lumborum muscle (p=0.01), with the MFR + R-TECAR group demonstrating greater improvement than R-TECAR alone. Other secondary outcomes, including TLF thickness and psychometric measures, improved over time but showed no significant between-group differences.

Conclusions: Combining MFR with R-TECAR for CNLBP did not produce superior outcomes compared with individual treatments though certain muscle-specific benefits were observed. Future research should focus on optimizing treatment parameters, extending intervention and follow-up periods, and exploring individualized approaches to maximize therapeutic efficacy.

Trial Registration: Chinese Registry of Clinical Trials: ChiCTR2400087961

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