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

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.