Efficacy of Myofascial release in improving the flexibility of Erector Spinae and Thoracolumbar Fascia in subjects with Chronic Low Back Pain - a Sonoelastographic analysis

The current study will be performed after the approval of the Ethical Committee

Informed consent will be obtained from each subject included in this study. All patients will be subjected to the following:

A clinical data will be collected, including body mass index and duration of Low back pain.

The participants will be randomly assigned to one of the two groups. The assessments of tissue stiffness and thickness will be performed by a Musculoskeletal Ultrasonography consultant .

The subjects will be then asked to adopt a prone position with their head in a neutral position and the L2 and L3 interspinous space was localized by manual palpation by a musculoskeletal ultra sonographer and evaluates the thoracolumbar fascia thickness. The probe will be then placed 2 cm lateral to this mark on the right and left sides to evaluate the stiffness of erector spinae.

After these measurements a physiotherapist applies either the Myofascial therapy or the simulated Myofascial therapy according to group allocation. The myofascial therapy group undergoes an initial Superficial myofascial release for warming up by deep sliding across the back followed by deep myofascial release techniques. The simulated group undergoes a sham myofascial release there with superficial gliding.

the post-treatment assessment  comprising the sonoelastographic evaluation on stiffness of erector spinae and thoracolumbar fascia and thickness of thoracolumbar fascia using B mode ultrasound will be evaluated. Pain measurements and trunk flexibility  and physical function will be performed before treatment  and  after treatment .