Myofascial Release for Back Pain
Most cases of back pain are the result of repeated physical stress or chronic conditions. Pain can occur anywhere along the back, and it is most common in the lower back.
Myofascial Release (MFR) is a whole body, hands-on approach to treatment that produces a profound healing effect upon the body tissues, eliminates pain, and restores motion. It has been proven to alleviate pain throughout the body, including the back.
What is Myofascial Pain?
The word “myofascial” can be broken into two parts: “myo,” which refers to muscles, and “fascia,” which is the tough, dense connective tissue that stretches in a web-like fashion throughout the body and covers the muscles. The fascia surrounds every muscle, bone, nerve, blood vessel, and organ in the body, much like shrink wrap.
Fascia should be flexible and relaxed, able to move without restriction. In some people, such as those who have endured physical trauma, repetitive stress injuries, scarring, inflammation, or have maintained poor posture, the fascia becomes less pliable. When it loses its flexibility, it then becomes a source of tension for the whole body. Traumatized fascia can exert excessive pressure that produces pain or a decreased range of motion, affects flexibility and stability, and even hinders the ability to cope with strain and stress.
How Does Myofascial Release Help Back Pain?
Depending upon the nature of the back pain, the myofascial therapist will target different muscles and muscle groups for breaking up adhesions in the fascia. As these adhesions are released, the pain disappears and normal functioning of the muscle returns.
Upper back pain often is a result of restrictions in the rhomboids, trapezius, and levator scapulae—all of which also attach to the neck. Midback pain is impacted by muscles including the erector spinae, serratus muscles, and latissimus dorsi. For low back pain, the myofascial release therapist may work with the extensor, flexor, and/or oblique muscles found in the low back, hip, and abdominal areas, most notably the quadratus lumborum, rectus abdominis, psoas, and piriformis.
The extensor muscles, attached to the back of the spine, enable standing and lifting objects. These muscles include the large paired muscles in the lower back (erector spinae), which help hold up the spine, and the gluteal muscles found in the hips. The flexor muscles (including the abdominal muscles), attached to the front of the spine, enable flexing, bending forward, lifting and arching the lower back. Finally, the oblique muscles are attached to the sides of the spine and help rotate the spine and maintain proper posture.
What Happens at a Myofascial Release Treatment Session?
The myofascial therapist will first evaluate the fascial system by visually observing the physical frame and by palpating, or feeling, the tissue texture and various fascial layers. When the therapist has determined where the fascial restrictions lie, he or she will apply gentle pressure in the direction of the restriction, maintaining the gentle pressure until barrier upon barrier is released and freedom is felt.
Specific techniques used are soft-tissue mobilization, releasing of trigger points found in the previously mentioned muscle groups, craniosacral manipulation, and myofascial unwinding. Soft-tissue mobilization techniques break up surface-level cross-restrictions of the collagen. The therapist can then move in more deeply with myofascial release to break down barriers within the deeper layers of the fascia, resulting in changing the viscosity of the ground substance. Once the fascia is able to unwind from abnormal twists and turns, the client usually experiences greater structural integrity and better functioning of the nerves, organs, vessels, and glands.
In addition, those receiving treatment may receive education on proper body mechanics and wearing appropriate shoes. Special stretches and exercises may be recommended, along with relaxation techniques such as meditation and deep breathing. Finally, the therapist may also provide nutritional advice, hypnosis, biofeedback, or counseling.
Is Myofascial Release Safe for Relieving Back Pain?
Myofascial release appears to be a safe health-care approach if provided by a properly trained practitioner. Practitioners, who often include physicians, physical therapists, and massage therapists, are versed in avoiding areas of caution and ensuring emotional safety, comfort, and privacy with pillows and draping. It is important to note that there may be some physical discomfort in the process of releasing long-held adhesions in deep layers of fascia.
What Causes Back Pain?
There are a number of reasons why a person may experience back pain. Physical stress can occur as a result of a lack of exercise, weight gain (especially in the abdomen), and incorrect posture. All of these situations can put a back’s natural curves out of alignment.
Some people experience strains, sprains, or spasms. These usually result from lifting, bending, twisting, sitting, or standing incorrectly. In these circumstances, pain may occur immediately or several hours later.
Herniated disks can bring about back pain. In this condition, a disk or disks in the spine bulge or even break. A common result is pressing, or “impinging,” on a spinal nerve. Impingement can cause numbness or shooting pain in the arms or legs. Sciatica is a condition in which the sciatic nerve is pinched or irritated. This often causes pain that runs down the lower back and down one leg.
The wear and tear of osteoarthritis can also cause back pain. With age, disks may narrow and vertebrae may develop bony growths. These can rub together resulting in back pain and stiffness.
Emotional stress and tension also can take a toll on the back, causing the muscles to tense. This increases the likelihood of pain or muscle spasms. It also may make any existing symptoms worse.
A variety of other health conditions can cause back pain. These include osteoporosis, or brittle bones. Cancer, infection, and other health problems can also be the cause. Additionally, structural problems, such as lordosis (commonly referred to as “swayback”) or scoliosis, a sideways curve in the spine, can cause back pain. Finally, due to weight gain and changes in posture, pregnancy often precipitates back pain in expectant mothers.
Davies, Clair and Amber Davies. (2001). The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. New Harbinger Publications, Inc: Oakland, CA.
Knaster, M., Discovering the Body’s Wisdom. 1996. New York: Bantam Books.
MyofascialRelease.com offers various articles on Myofascial Release.
Take Care of Your Back: Helping Relieve and Prevent Back Pain (1998), Channing-Bete Company.
Spine Relief has additional information on back muscles and low back pain.