Chronic Low Back Pain And Thoracolumbar Fascia

Chronic Low Back Pain & The Thoracolumbar Fascia 

The thoracolumbar fascia is a structure in the lower back that is made up of layers of densely packed collagen and elastic fibers separated by loose connective tissue. This allows the deep stabilizing muscles in the lower back to move independently of the superficial muscles used for twisting and bending forward and backward. When adhesions form in the fascia, movement can become restricted, leading to pain and disability in the lower back and nearby parts of the body. A January 2023 study that included 131 adults—68 with low back pain—revealed a 25-30% reduction in thoracolumbar fascia elasticity among those with low back pain. This suggests that improving the function of the thoracolumbar fascia is essential in the management of low back pain. So, what can your doctor or chiropractor do to improve the elasticity of these important tissues?

The most common technique used to address adhesions in the thoracolumbar fascia is a manual therapy technique called myofascial therapy or myofascial release. Myofascial release is a hands-on treatment in which a doctor or chiropractor applies pressure with their hands, elbow, or a tool to stretch the muscles to knead out trigger points or adhesions that may inhibit the ability of the muscles to slide against one another during normal movements. In the last thirty years, various forms of myofascial therapy have been developed and disseminated to healthcare professionals who apply hands-on care, including doctors of chiropractic. In addition to care provided in the office, patients may also be instructed on self-myofascial release, which may include using a foam roller.

Two systematic reviews conducted in 2021 concluded that myofascial therapy is effective for reducing disability and pain in patients with low back pain¹. More recently, a 2023 study that included 48 patients with low back pain found that those treated with a single session of myofascial therapy experienced significant improvement in pain and disability². Therefore, myofascial therapy is an effective treatment option for managing low back pain.