Graston Technique and Chronic Low Back Pain
Instrument assisted soft tissue mobilization (IASTM) is a new form of non-invasive practice modality that enables clinicians to treat suspected soft tissue dysfunction. After identifying a potential restriction within the tissue clinicians mobilize the target area utilizing an implement for the purposes of normalizing tissue health and biomechanics. Previous studies have shown that the application of IASTM has measureable morphological changes in the fibroblast activity and therefore tissue organization and health.
Considering these things, the current authors sought to investigate the role, if any, that graston technique would have on patients with chronic low back pain (CLBP). Overall, it was shown that when treated with IASTM for a four week period there was a significant increase in mobility and decrease in pain in patients with CLBP.
30 patients with CLBP (>90 days of symptoms) were included in the study. ROM was measured with a hip ROM inclinometer application using a smartphone and pain was assessed via the visual analog scale (VAS). Standardized Graston technique was applied to 15 patients whereas general exercise was applied to the control group.
Due to the complexity of CLBP, a multimodal approach incorporating manual therapy, exercise, education and modalities is often implemented. IASTM is a relatively new treatment approach that allows the clinician to rapidly effect difficult and dense soft tissue, such as the low back while preserving their own health.
Using a standardized IASTM approach for low back pain, the authors demonstrated a significant decrease in pain pre and post 4 week intervention (50.6 vs. 25.5 with VAS) as well as lumbopelvic ROM. Despite these things, the control group of exercise alone also showed a significant improvement in outcomes. It is apparent that IASTM offers a tangible means to treat LBP, however the current study also points out that it does not replace the importance of incorporating exercise into treatment planning as well.
> From: Lee et al., J Phys Ther Sci 28 (2016) 1852-1855(Epub ahead of print). All rights reserved to The Society of Physical Therapy. Click here for the online summary.