Effects of Myofascial Release Technique on Pain and Disability in Patients with Chronic Lumbar Disc Herniation: A Randomized Trial

Abstract

Background Disc herniation is one of the factors that causes low back pain (LBP).

Objective This study aimed to evaluate the effect of a myofascial release technique on pain and disability in patients with chronic lumbar disc herniation.

Method 30 patients with a herniated lumbar disc, divided into 2 groups. One group (n=15) received electrotherapeutic modalities (TENS, pulsed ultrasound, hot packs) in addition to the myofascial release technique (MFR) on trigger points in 9 soft tissue elements. The other group (n=15) received only electrotherapeutic modalities. All patients underwent 10 treatment sessions. In both groups we assessed back and lower extremity pain intensity, functional disability level and trigger point pain threshold before treatment and after 5 and 10 sessions.

Results For back pain, the median between-group differences (95% CI) compared to baseline were 2 (1–2) after the 5th session and 2 (1–4) after the 10th session; the difference between the 5th and 10th sessions was 1 (0–2). For functional disability, the mean between-group differences (95% CI) compared to baseline were 5 points (1.8–8.1) after the 5th session and 8.3 points (4.2–12.3) after the 10th session; the difference between the 5th and tenth sessions was 3.34 points (1.02–5.6). For trigger point pain threshold, the mean between-group differences compared to baseline were −1.47 kg/cm² (−1.7 to − 1.17) after the 5th session and −3.17 (−3.6 to −2.7) after the 10th session; the difference between the 5th and 10th sessions was −1.7 kg/cm² (−2.04 to −1.3).

Conclusion In conclusion, MFR might be an effective treatment for reducing pain and disability in patients with chronic lumbar disc herniation.

Zusammenfassung

Hintergrund Bandscheibenherniation ist eine der Ursachen für Schmerzen im Bereich der Lendenwirbelsäule.

Ziel Ziel dieser Studie war die Bewertung der Wirkung von myofaszialen Releasetechniken (MFR) auf Schmerz und Funktionseinschränkung bei Patienten mit chronischer Bandscheibenherniation der Lendenwirbelsäule.

Methoden 30 Patienten mit Bandscheibenherniation der Lendenwirbelsäule wurden in 2 Gruppen aufgeteilt. Eine Gruppe (n=15) erhielt elektrotherapeutische Anwendungen (transkutane elektrische Nervenstimulation (TENS), Ultraschalltherapie (Impulsschall), Wärmeanwendungen) und zusätzlich myofasziale Releasetechniken (MFR) an Triggerpunkten in 9 Weichgewebebereichen. Die andere Gruppe (n=15) erhielt nur elektrotherapeutische Anwendungen. Alle Patienten erhielten 10 Behandlungseinheiten. In beiden Gruppen wurde vor der Behandlung und jeweils nach der 5. und 10. Behandlungseinheit die Schmerzintensität im Rücken und in den unteren Extremitäten sowie der Grad der Funktionseinschränkung und die Schmerzschwelle der Triggerpunkte bewertet.

Ergebnisse Bei Rückenschmerzen betrug der durchschnittliche Unterschied zwischen den Gruppen (95% CI) bezogen auf die Eingangswerte 2 (1–2) nach der 5. Behandlungseinheit und 2 (1–4) nach der 10. Behandlungseinheit; der Unterschied zwischen der 5. und 10. Behandlungseinheit betrug 1 (0–2). Bei der Funktionseinschränkung betrug der durchschnittliche Unterschied zwischen den Gruppen (95% CI) bezogen auf den Eingangswert 5 Punkte (1,8–8,1) nach der 5. Behandlungseinheit und 8,3 Punkte (4,2–12,3) nach der 10. Behandlungseinheit; der Unterschied zwischen der 5. und 10. Behandlungseinheit betrug 3,34 Punkte (1,02–5,6). Bei der Schmerzschwelle der Triggerpunkte betrug der durchschnittliche Unterschied zwischen den Gruppen bezogen auf den Eingangswert −1,47 kg/cm2 (−1,7 – −1,17) nach der 5. Behandlungseinheit und −3,17 (−3,6 – −2,7) nach der 10. Behandlungseinheit; der Unterschied zwischen der 5. und 10. Behandlungseinheit betrug −1,7 kg/cm2 (−2,04 – −1,3).

Schlussfolgerung Aus der Studie kann geschlossen werden, dass myofasziale Releasetechniken (MFR) zusätzlich zu passiven Therapiemaßnahmen bei Patienten mit chronischer Bandscheibenherniation der Lendenwirbelsäule in Bezug auf Schmerzreduktion und Reduzierung der Funktionseinschränkung eine größere Wirkung hat als ausschließlich passive Therapiemaßnahmen.

Key words

myofascial release technique - disc herniation - Trigger points - pain

Schlüsselwörter

Triggerpunkte - Querschnittlähmung - Physiotherapie

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