Effect of Roptrotherapy on Pressure-Pain Thresholds in Patients with Subacute Nonspecific Low Back Pain

Abstract

Objective: To investigate 1. the pressure pain thresholds [PPTs] with respect to muscles related to low back pain [LBP] and to a muscle unrelated to lower back region, and 2. to explore the effect of deep cross-friction massage sessions [roptrotherapy] on PPTs, pain sensitivity and disability.

Methods: Sixty-five consecutive patients with subacute non-specific LBP were allocated in this clinical trial. The primary outcome measures were the PPTs of levels L1, L3, and L5 of the erector spinae and the gluteus maximus. The middle of the left triceps brachii was chosen as a neutral measuring point unrelated to LBP. Additionally, pain rating and disability variables were examined. In order to establish reference values, 64 healthy subjects [control group] were examined with respect to similar PPTs.

Results: The mean PPT values of the erector spinae and the gluteus maximus of the LBP group were significantly lower in comparison to the PPT values of the healthy group. The correlation between having LBP and PPT was highest at the L3 level of the erector spinae [r = –0.73, P < 0.001]. At baseline, the PPTs of the erector spinae levels increased after the roptrotherapy sessions, yielding a situation in which the patients no longer had back complaints, while the neutral triceps brachii remained unchanged over the entire time.

Conclusion: Subacute nonspecific LBP may be modulated by central pain processing but the partial effect of roptrotherapy may be explained rather as local restoration of connective tissues in lumbar erector spinae and buttock musculature.

KEYWORDS:

• Low back pain
• pressure-pain thresholds
• central sensitization
• cross-friction massage
• myofascial T-bar
• roptrotherapy