Myofascial Release for Chronic Low Back Pain: A Systematic Review and Meta-Analysis

Zugui Wu, Yi Wang, Xiangling Ye, Zehua Chen, Rui Zhou, Zixuan Ye, Jinyou Huang, Yue Zhu, Guocai Chen, Xuemeng Xu, Zugui Wu, Yi Wang, Xiangling Ye, Zehua Chen, Rui Zhou, Zixuan Ye, Jinyou Huang, Yue Zhu, Guocai Chen, Xuemeng Xu

Abstract

Background: Chronic low back pain (CLBP) is one of the most common musculoskeletal diseases in the elderly, which has a severe impact on the health of the elderly. However, CLBP treatment is very challenging, and more effective treatment methods are needed. Myofascial release may be an effective therapy for the management of chronic musculoskeletal pain. It is widely used clinically to treat CLBP, but its clinical efficacy is still controversial. Objective: This study aims to systematically evaluate the effectiveness of myofascial release for patients with CLBP. Methods: We selected PubMed, Cochrane Library, EMBASE database, and Web of Science database articles published until April 5, 2021. Randomized controlled trials (RCTs) of myofascial release for CLBP were included. Outcome measures included pain, physical function, quality of life, balance function, pain pressure-threshold, trunk mobility, and mental health. For each outcome, Standardized mean differences (SMD) or mean differences (MD) and 95% confidence intervals (CIs) were calculated. Results: Eight RCTs (n = 375) were included based on inclusion and exclusion criteria. The meta-analysis showed that the overall efficacy of myofascial release for CLBP was significant, including two aspects: pain [SMD = -0.37, 95% CI (-0.67, -0.08), I 2 = 46%, P = 0.01] and physical function [SMD = -0.43, 95% CI (-0.75, -0.12), I 2 = 44%, P = 0.007]. However, myofascial release did not significantly improve quality of life [SMD = 0.13, 95% CI (-0.38, 0.64), I 2 = 53%, P = 0.62], balance function [SMD = 0.58, 95% CI (-0.49, 1.64), I 2 = 82%, P = 0.29], pain pressure-threshold [SMD = 0.03,95% CI (-0.75, 0.69), I 2 = 73%, P = 0.93], trunk mobility [SMD = 1.02, 95% CI (-0.09, 2.13), I 2 = 92%, P = 0.07] and mental health [SMD = -0.06, 95% CI (-0.83, 0.71), I 2 = 73%, P = 0.88]. Conclusions: In this study, we systematically reviewed and quantified the efficacy of myofascial release in treating CLBP. The meta-analysis results showed that myofascial release significantly improved pain and physical function in patients with CLBP but had no significant effects on balance function, pain pressure-threshold, trunk mobility, mental health, and quality of life. However, due to the low quality and a small number of included literature, more and more rigorously designed RCTs should be included in the future to verify these conclusions.

Keywords: chronic low back pain; complementary therapy; meta-analysis; myofascial release; review.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Wu, Wang, Ye, Chen, Zhou, Ye, Huang, Zhu, Chen and Xu.

Figures

Figure 1
Figure 1
Flowchart of meta-analysis search and selection process.
Figure 2
Figure 2
Risk of bias graph.
Figure 3
Figure 3
Meta-analysis on pain.
Figure 4
Figure 4
Meta-analysis on physical function.
Figure 5
Figure 5
Meta-analysis on quality of life.
Figure 6
Figure 6
Meta-analysis on balance function.
Figure 7
Figure 7
Meta-analysis on pain pressure-threshold.
Figure 8
Figure 8
Meta-analysis on trunk mobility.
Figure 9
Figure 9
Meta-analysis on mental health.
Figure 10
Figure 10
Funnel plot.

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