Practical measurement of changes in leg length discrepancy after a myofascial release on the thoracolumbar fascia in patients with acute low back pain. A pilot study.

Mapping Intimacies ◽

10.31236/osf.io/wvkgr ◽

2021 ◽

Author(s):

Andreas Brandl

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Leg Length ◽

Thoracolumbar Fascia ◽

Myofascial Release ◽

Acute Low Back Pain ◽

Length Discrepancy ◽

Practical Measurement

Background: A relationship between leg length discrepancy (LLD), pelvic obliquity and acute low back pain (aLBP) is discussed in recent work. Myofascial release (MFR) techniques are probably one approach to tread aLBP. It is proposed to use anamnestic LLD survey in aLBP patients. The aim of this study is to evaluate a practical measurement of LLD and the feasibility of MFR in the setting of a randomized control trial (RCT).Methodology: In 12 subjects (7 female, 5 male) with aLBP and a LLD greater than 3 mm, a MFR technique was performed on the thoracolumbar fascia. At baseline, post-intervention and follow-up, LLD was measured with a cross-line laser, pain with the visual analogue scale (VAS) and finger floor distance (FFD). Patients completed a survey after follow-up to assess their acceptance of the study procedure. The therapist evaluated the methods in terms of practicability.Results: The cost on time and resources for the LLD measurement and the MFR treatment was low. The participants voted with medium to high acceptance for the study procedure. The LLD decreased by 5.00 mm after treatment and by 4 mm to follow-up. The minimum detectable changes were exceeded in 7 out of 12 cases after intervention and in 2 of 9 cases at follow-up. The VAS showed a reduction in pain of 17.50 mm to follow-up but not after treatment. The FFD revealed no clinically relevant differences.Conclusion: Measurement of LLD is applicable in daily practice in a manual therapy setting, but it cannot be assumed to be a valid method for an RCT. Valid methods such as video raster stereography are therefore recommended. A comprehen-sive RCT with an MFR arm to investigate the impact of this intervention on leg length is feasible.

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Immediate Effects of Myofascial Release on the Thoracolumbar Fascia and Osteopathic Treatment for Acute Low Back Pain on Spine Shape Parameters: A Randomized, Placebo-Controlled Trial

Life ◽

10.3390/life11080845 ◽

2021 ◽

Vol 11 (8) ◽

pp. 845

Author(s):

Andreas Brandl ◽

Christoph Egner ◽

Robert Schleip

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Controlled Trial ◽

Low Back ◽

Shape Parameters ◽

Leg Length ◽

Kyphotic Angle ◽

Thoracolumbar Fascia ◽

Acute Low Back Pain ◽

Spine Shape

Background: Spine shape parameters, such as leg length and kyphotic or lordotic angle, are influenced by low back pain. There is also evidence that the thoracolumbar fascia plays a role in such pathologies. This study examined the immediate effects of a myofascial release (MFR) technique on the thoracolumbar fascia and of an osteopathic treatment (OMT) on postural parameters in patients with acute low back pain (aLBP). Methods: This study was a single-blind randomized placebo-controlled trial. Seventy-one subjects (43.8 ± 10.5 years) suffering from aLBP were randomly and blindedly assigned to three groups to be treated with MFR, OMT, or a placebo intervention. Spinal shape parameters (functional leg length discrepancy (fLLD), kyphotic angle, and lordotic angle) were measured before and after the intervention using video raster stereography. Results: Within the MFR group, fLLD reduced by 5.2 mm, p < 0.001 and kyphotic angle by 8.2 degrees, p < 0.001. Within the OMT group, fLLD reduced by 4.5 mm, p < 0.001, and kyphotic angle by 8.4°, p = 0.007. Conclusion: MFR and OMT have an influence on fLLD and the kyphotic angle in aLBP patients. The interventions could have a regulating effect on the impaired neuromotor control of the lumbar muscles.

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Thoracolumbar Fascia Enthesopathy as a Cause of Low Back Pain: A Retrospective and Follow-up Study

10.21203/rs.3.rs-219002/v1 ◽

2021 ◽

Author(s):

Ouidade A. Tabesh ◽

Roba Ghossan ◽

Soha H Zebouni ◽

Rafic Faddoul ◽

Michel Revel ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Iliac Crest ◽

Pain Syndrome ◽

Clinical Findings ◽

Complete Relief ◽

Low Back ◽

Thoracolumbar Fascia ◽

The Mean

Abstract Aim. To evaluate ultrasonography findings of Thoracolumbar Fascia (TLF) enthesis in patients with low back pain (LBP) due to iliac crest pain syndrome (ICPS). Method. The ultrasonographic and clinical findings of 60 patients with LBP due to ICPS were compared to those of 30 healthy volunteers with no LBP. Thickness of the TLF was measured with ultrasound (US) at its insertion on the iliac crest. Results. Forty-eight women and 12 men with a mean age of 42.1±11.3 years were diagnosed with ICPS. In patients, the mean thickness of the TLF was 2.51±0.70mm in affected sides compared to 1.81±0.44mm in the contralateral unaffected sides. The mean thickness difference of 0.82mm between the affected and non-affected sides was statistically significant (95%CI, 0.64-0.99, P<0.0001). In volunteers, the mean thickness of the TLF was 1.6±0.2mm. The mean thickness difference of 0.89mm between the affected sides of patients and volunteers was statistically significant (95%CI, 0.73-1.06, P<0.0001). Forty-two patients who didn’t improve with conservative therapy, received injections of methylprednisolone acetate and 1% lidocaine around the TLF enthesis. All patients reported complete relief of their LBP within 20 minutes of the injections thanks to the lidocaine anesthetic effect. Fifty-six (93.3%) patients were reached by phone for a long-term follow-up. Among them, 33 (58.9%) patients experienced a sustained complete pain relief after a mean follow-up of 45±19.3 months (range, 3-74 months). Conclusion. our findings suggest that TLF enthesopathy is a potential cause of nonspecific LBP that can be diagnosed using US.

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