The effect of manual therapy on abdominal scars in patients with nonspecific chronic low back pain - a double-blind,...

Manual therapy in the treatment of scars has garnered significant interest in recent years. However, there is a paucity of literature addressing these tissues in patients with nonspecific chronic low back pain (CLBP), and there are limited studies on the subject. The objective of this study was to analyze the effect of scar release in the lower abdominal region in patients with nonspecific chronic low back pain.

Forty-four participants were recruited and randomly divided into three groups: the control group, where patients lay down for 5 min; the placebo group, where participants received therapist touch for 5 min in the suboccipital region; and the treatment group, where individuals received intervention on abdominal scars for 5 min. Inclusion criteria were men or women aged 18-70 with chronic low back pain who had undergone abdominal surgery between the umbilical scar and the pubic symphysis. Pain levels, disability, and range of motion were measured for all participants, with follow-ups at 10 and 20 days post-intervention.

Both the placebo and treatment groups showed a significant improvement in the Visual Analog Scale (VAS) at T1 and T2 compared to the control group (P < 0.05); however, there was no significant difference between the placebo and treatment groups. The treatment group exhibited a high Effect Size at T1 when analyzing VAS and Pressure Pain Thresholds (PPT) of the paravertebral mass and spinous processes compared to the control group, while the placebo group showed a medium Effect Size compared to the control group. Disability levels and flexibility of the spine and lower limbs, however, did not show significant differences between groups and different time points.

This study suggests that mobilizing scar tissues in patients with nonspecific chronic low back pain for 10 min does not show a significant difference compared to releasing suboccipital muscles for 5 min, immediately after as well as in follow-ups. However, due to the high Effect Size, it confirms the potential acute effect of manual therapy on scar tissues in patients with nonspecific chronic low back pain.