Effects of Joint Mobilization and Myofascial Release on Muscle Thickness in Non-Specific Low Back pain: A randomized Clinical Trial

Background: Non-specific low back pain is a discomfort that affects individuals at any point in their lives. The study aim was to find the effects of Myofascial Release and Joint Mobilization on muscle thickness through ultrasonography in individuals experiencing non-specific low back pain. Methods: This double-blinded randomized clinical trial was conducted on 84 participants via convenient sampling. The interventions were given among three groups; joint mobilization, myofascial release and a combination of joint mobilization and myofascial release, with a common treatment of lumbar heating for 15 minutes and trunk stabilization exercises. Data was collected on a two-week treatment regimen (Days 1, 4, 8, and 12) and a one-month follow-up. Ultrasound evaluations were used to measure the thickness of deep Lumbar muscles at rest and contraction i.e. transverse abdominis (rTrA, cTrA) and lumbar multifidus (rLM, cLM). Repeated measure ANOVA was utilized to analyze follow-ups within groups and between groups, with post-hoc tests conducted to identify specific differences. Results: Significant increases in muscle thickness were observed over time in the transverse abdominis, with improvements in both rTrA (right, p = 0.001; left, p = 0.001) and cTrA (right, p = 0.001; left, p = 0.008). The lumbar multifidus also demonstrated significant changes, with increases in rLM (right, p = 0.001; left, p = 0.047) and cLM (right, p = 0.004; left, p = 0.037). However, the group main effects showed no significant differences on muscle thickness between the groups. Conclusions: Joint mobilization demonstrated increased effectiveness in improving muscle thickness relative to myofascial release and combining both treatments for individuals with non-specific low back pain. Future studies should address the sample diversity, gender distribution, and muscle composition assessment along with demographic and lifestyle factors.