Myofascial release for chronic low back pain: meta-analysis of 8 randomised trials

Myofascial release — slow, sustained manual pressure and stretch applied to muscle and its connective tissue — is a core technique in clinical massage for chronic low back pain. This systematic review asked what randomised trials actually show, pooling 8 RCTs with 375 participants.

The headline numbers favour the technique: compared with control interventions, myofascial release produced statistically significant improvements in both pain (standardised mean difference −0.37) and physical function (−0.43). These are small-to-moderate effects of the size typical for hands-on treatments in chronic pain.

The subgroup analysis adds essential nuance. The benefit was clearest when myofascial release was compared against sham treatment; when compared against active interventions such as exercise or spinal manipulation, it showed no additional advantage. Outcomes beyond pain and function — quality of life, balance, trunk mobility, mental health — showed no significant change. The authors also flag that the included trials were small and of low methodological quality, so the pooled estimates should be read cautiously.

The practical interpretation mirrors much of the manual-therapy literature: myofascial release does something real for symptoms, but it is an adjunct to — not a replacement for — active rehabilitation, which remains the backbone of chronic low back pain care.

Key findings

• 8 randomised controlled trials with 375 participants with chronic low back pain were pooled.
• Myofascial release significantly improved pain versus control (standardised mean difference −0.37).
• Physical function also improved significantly (standardised mean difference −0.43).
• Subgroup analysis showed benefits mainly against sham treatment — not over exercise or spinal manipulation.
• No significant effects were found for quality of life, balance, trunk mobility or mental health, and included trials were small and of low quality.

Clinical relevance

For clients with chronic low back pain, hands-on myofascial work can reduce symptoms and make movement more tolerable — and that window of relief is most valuable when it is used to progress an active program. That is how our RMTs and kinesiologists pair treatment: soft-tissue work to settle symptoms, exercise to change the trajectory.

Prepared by the Volt Health team as an educational summary of the cited publication. It is not medical advice; assessment and treatment decisions should always be made with a qualified health professional.