Low Back Pain and MFR
A perspective on low back pain, and the John Barnes method of Myofascial Release (MFR).
“Piezoelectricity” refers to the production of electrical charges on the surfaces of a crystal specimen by the imposition of some form of “stress”. 1 The human fascial system, which covers every cell of the body, is a crystalline structure.
The Medical Perspective
Low back pain is very common complaint everywhere, and it effects almost all of us at some point in our lifetime. It is the second most frequently reported illness in industrialized countries, next to the common cold. 2
Disc herniations are a very popular diagnosis with chiropractors and surgeons primarily because they readily show up with modern diagnostic imaging. However, it has been reported that only four percent of low back pain is due to a herniated disc. 3 One study found a 92 percent return-to-work rate in a group treated conservatively (without surgery), even though 60 percent had muscle weakness and 26 percent showed disc rupture on the CT scan. 4
According to some experts in the medical professions, the causes of 90 percent of low back pain are musculoskeletal and mechanical in nature. This type of low back pain is the result of overuse or straining, spraining, lifting, or bending that results in ligament sprains, muscle pulls, or disc herniations. Ligament injury often involves very small micro-tears which usually do not show up well on these investigations and so have been largely overlooked. 5
An even more common condition, relating to the ligaments and tendons, is fascial restrictions causing tight, shortened psoas muscles.
The psoas muscles are at the skeletal core. On each side of the spine, they attach to the lateral and anterior aspect of the twelfth vertebra and to each of the lumbar vertebra. They insert through a tendon at the top of the femur.
When a person feels low back pain it is natural to assume that it is the more superficial muscles, that can be “touched”, that cause the pain. That is only partially true. If only those muscles are released, the relief is merely temporary. “My back felt great until I made it to the parking lot,” is a common comment experienced with typical massage. The real source of the pain is most often constricted psoas muscles.
The tightening of the psoas can lead to a number of complications. “Inevitably, other muscle groups become involved in compensating for the loss of structural integrity. The pelvic bowl tips forward, shrinking the distance between the pelvic crests and the legs, and the femurs are compressed into the hip sockets. To compensate for this constriction, the thigh muscles become overdeveloped. Since full rotation of the thighbones can no longer occur in the hip joints, much of the rotational torque is transferred to the knees and the lumbar spine—a recipe for knee and lower back injuries.” 6
Releasing the Psoas
Due to the nature and position of the psoas muscles (not readily accessible, and not easy to work on,) they are mostly neglected when it comes to treating low back pain. Yet, they are very often the primary source of the pain. The pain sensations arise from the muscles being in a constant state of contraction and are being compressed by fascial restrictions.
“The John F. Barnes’ Myofascial Release Approach® consists of the gentle application of sustained pressure into fascial restrictions within the body.” 7 It involves stretches and compressions, applied with gentle pressure, that are held until the restriction releases. “This essential “time element” has to do with the viscous flow and the piezoelectric phenomenon: a low load (gentle pressure) applied slowly will allow a viscoelastic medium (fascia) to elongate.” 8 A piezoelectrically induced current activates the healing processes in the stimulated area. 9
The fascia is a crystalline piezoelectric tissue; therefore, a gentle sustained pressure of myofascial release through compression, stretching or twisting of the myofascial system generates a flow of bio-energy throughout the mind-body complex by the piezoelectric phenomenon. 10
Although direct pressure to the deeper layers in the abdominal area is sometimes possible, it can be somewhat painful, and is not always possible with certain (heavier) body types.
There are several other methods for releasing the psoas muscles which involve strategic stretching techniques, which are gently held for periods of time long enough to facilitate the fascial releases. It is generally recommended that 90 to 120 seconds is the minimum time before the releasing action begins. Some studies have indicated that four minutes is an optimal time. There are many factors involved such that there is not any specific amount of time required to adequately complete the process. It is important that the therapist have a “feel” for what is happening under their hands to know when the process is completed. It may take several session for this to happen in more extreme cases.
Some stretches require the service of the therapist but many can, and should, be done on a regular basis as self treatments. (See the: Self Treatment: How to help yourself! section at http://thereleaseconnection.com/resources-and-information/)
Physical trauma, inflammation or postural misalignment can cause fascial restrictions leading to pressure on pain sensitive structures. This excessive pressure acts as a “straight jacket” in our body, producing symptoms such as pain, headaches or limited range of motion. The modality of MFR uses sustained pressure and gentle stretching or compression into the fascial system, allowing it to regain fluidity and relieve the tension of this connective tissue. 11
In the case of low back pain, caused by fascial restrictions, a complete releasing the psoas muscles takes care of the problem at it source.
“I had no back, hip, or leg pain at all last night! None! Took a while to get to sleep because I kept waiting for the pain to start so I could readjust. Didn’t happen. Such a good night! Thank you again, my dear Curt.” —– M. E.
Curt Redd, LMT
- . Frymoyer JW and Cats-Baril WL. An overview of the incidences and costs of low back pain. Orthopedic Clinics of North America. 1991. 22:263-271.
- Ombregt L, Bisschop P, and ter Veer HJ. A System of Orthopaedic Medicine, Second Edition. Churchill Livingstone. 2003. p 775.
- Alaranta H. A prospective study of patients with sciatica. Spine. 1990. 15:1345-1349.
- Borenstein DG. Chronic low back pain. Rheumatological Disease Clinics of North America. 1996. 22:439-456.
- 6. http://www.yogajournal.com/practice/170?page=2
Piezoelectric jpg: http://bioacoustics.blogspot.com/2012_02_01_archive.html
Psoas picture: https://www.facebook.com/147107135344108/photos/a.147110562010432.36040.147107135344108/558590954195722/?type=1&permPage=1 http://www.yogajournal.com/practice/170?page=2
1. Alderman D. Prolotherapy for Musculokeletal Pain. Pract Pain Mgt. Jan/Feb 2007. 7(1):10-15.
4. Practical PAIN MANAGEMENT, May 2007 59 ©2007 PPM Communications, Inc. Prolotherapy for Low Back Pain By Donna Alderman, DO
A Reasonable and Conservative Approach to Musculoskeletal Low Back Pain, Disc Disease, and Sciatica