Efficacy of Myofascial Release versus Positional Release Technique on Pain and Functional Ability in Patients with Mechanical Low Back Pain

Abstract

Background: Mechanical low back pain is a common musculoskeletal disorder in which pain, disability, restricted lumbar movement, and myofascial dysfunction can interfere with daily activities. Myofascial Release (MFR) and Positional Release Technique (PRT) are manual therapy approaches that act through different mechanical and neurophysiological mechanisms. Objective: To compare the efficacy of MFR and PRT on pain intensity, functional ability, and lumbar range of motion in patients with mechanical low back pain. Methods: A randomized clinical trial with a two-group parallel design was conducted in the Physiotherapy Department of People’s Hospital. Thirty participants were recruited and allocated equally to Group A (MFR, n=15) and Group B (PRT, n=15). Both groups received three sessions per week for four weeks (12 sessions), with each session lasting approximately 45 minutes. Pain was assessed by the Visual Analogue Scale (VAS), functional disability by the Oswestry Disability Index (ODI), and lumbar mobility by the modified Schober’s test. Paired t-tests assessed within-group change, independent t-tests assessed between-group differences, and Pearson correlation examined the relationship between pain reduction and functional improvement. Results: VAS scores improved significantly in both groups: MFR from 6.92±1.15 to 2.35±0.78 and PRT from 6.85±1.22 to 2.52±0.84 (both p<0.001). The post-intervention VAS difference between groups was not significant (p=0.570). ODI improved from 44.1±8.2% to 19.2±5.1% in the MFR group and from 43.8±7.9% to 24.1±6.3% in the PRT group (both p<0.001); the greater mean ODI improvement with MFR (24.9 vs 19.7 percentage points) was significant (p=0.003). Lumbar flexion and extension increased significantly in both groups. Pain reduction and functional improvement showed a strong positive correlation (r=0.79, p<0.001). Conclusion: Both MFR and PRT are effective for pain reduction in mechanical low back pain, but MFR produced greater improvement in functional disability and may be preferred when the rehabilitation goal is broader functional restoration.