Role of Latissimus Dorsi–Thoracolumbar Fascia Complex Stretching on Pain and Pain-Related Parameters in Patients With Chronic Low Back Pain: A Randomised Clinical Trial

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-10-01 DOI:10.1002/ejp.70143

Naime Ulug, Seyde Busra Kodak, Muhammed İhsan Kodak, Sema Nur Aslan

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Abstract

Background

Fascial stretching is gaining interest as a potential intervention for pain management. However, evidence regarding the effect of latissimus dorsi–thoracolumbar fascia (LD-TLF) complex stretching in patients with chronic low back pain (CLBP) remains limited. Therefore, this study aimed to investigate the effects of LD-TLF complex stretching on pain-related factors and disability in patients with CLBP.

Methods

Thirty patients with CLBP were randomly assigned to a study group (n = 15; 7 men, 8 women) and a control group (n = 15; 7 men, 8 women). The study group received 4 weeks of LD-TLF complex stretching in combination with conventional physiotherapy, while the control group received conventional physiotherapy only. Outcomes were assessed before and after the interventions, including primary measures of pain pressure thresholds (PPT) at thoracolumbar fascia levels (L1, L3 and 12th costa), and secondary measures included the Pain Sensitivity Questionnaire (PSQ), the effects of pain on daily activities measured by the Brief Pain Inventory (BPI), and disability assessed by the Oswestry Disability Questionnaire (ODQ).

Results

Pre- and post-treatment PPTs, at the L1, L3 vertebrae and 12th costa levels, demonstrated significant differences between the study group and control groups. Post-treatment thresholds were significantly higher compared to pre-treatment thresholds (p < 0.001, ηp² = 0.67; p < 0.001, ηp² = 0.61; p < 0.001, ηp² = 0.74). Additionally, significant improvements were found in PSC, BPI and ODQ scores in the study group compared to the control group (p < 0.05).

Conclusion

The results of this study suggest that stretching the LD-TLF complex may be a beneficial addition to the conventional physiotherapy approach for patients with CLBP. Specifically, LD-TLF complex stretching, when used in combination with conventional physiotherapy, appears to provide improved pain thresholds, decreased pain sensitivity and pain during activity, as well as reduced disability compared to conventional physiotherapy alone in patients with CLBP.

Significance Statement

Chronic low back pain (CLBP) is a multifactorial condition, with the thoracolumbar fascia increasingly recognized as a potential contributing factor. This study suggests that stretching the latissimus dorsi-thoracolumbar fascia complex in combination with conventional physiotherapy, enhances pain thresholds, reduces pain sensitivity, and decreases disability in individuals with CLBP. Incorporating fascia-specific interventions into CLBP treatment programs could offer significant benefits for both patients and clinicians.

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背阔肌-胸腰筋膜复合体拉伸对慢性腰痛患者疼痛和疼痛相关参数的作用：一项随机临床试验

背景：筋膜拉伸作为疼痛管理的潜在干预手段正引起人们的兴趣。然而，关于背阔肌-胸腰筋膜（LD-TLF）复合拉伸在慢性腰痛（CLBP）患者中的作用的证据仍然有限。因此，本研究旨在探讨LD-TLF复合物拉伸对CLBP患者疼痛相关因素和残疾的影响。方法：30例CLBP患者随机分为研究组（n = 15，男性7例，女性8例）和对照组（n = 15，男性7例，女性8例）。研究组在常规物理治疗的基础上进行4周的LD-TLF复合拉伸，对照组仅进行常规物理治疗。评估干预前后的结果，包括胸腰筋膜水平（L1， L3和12 costa）疼痛压力阈值（PPT）的主要测量，次要测量包括疼痛敏感性问卷（PSQ），疼痛对日常活动的影响通过简短疼痛量表（BPI）测量，以及通过Oswestry残疾问卷（ODQ）评估残疾。结果：治疗前和治疗后，L1、L3椎体和第12椎体水平的PPTs在研究组和对照组之间存在显著差异。治疗后阈值显著高于治疗前阈值（p 2 = 0.67; p 2 = 0.61; p 2 = 0.74）。此外，与对照组相比，研究组的PSC、BPI和ODQ评分均有显著改善(p)。结论：本研究结果表明，拉伸LD-TLF复合物可能是CLBP患者常规物理治疗方法的有益补充。具体来说，与传统物理治疗相比，LD-TLF复合拉伸与传统物理治疗联合使用时，似乎可以改善CLBP患者的疼痛阈值，降低疼痛敏感性和活动时的疼痛，并减少残疾。意义声明：慢性腰痛（CLBP）是一个多因素的疾病，胸腰筋膜越来越被认为是一个潜在的因素。本研究表明，伸展背阔肌-胸腰筋膜复合体与常规物理治疗相结合，可以提高CLBP患者的疼痛阈值，降低疼痛敏感性，并减少残疾。将筋膜特异性干预纳入CLBP治疗方案对患者和临床医生都有显著的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.