Effect of Therapeutic Manipulation of Superficial Back and Front Myofascial Lines in a Bank Employee with Chronic Low Back Pain: A Case Report

Abstract

Background: Chronic low back pain (CLBP) is common among office workers and may be influenced by prolonged sitting, altered lumbopelvic control and impaired soft-tissue mobility. Myofascial-line approaches are used clinically to address movement restrictions beyond the painful lumbar region although evidence for the use of superficial back and front lines remains limited. Case Presentation: A 38-year-old woman employed in a bank presented with a 3-month history of bilateral, non-radicular low back pain and thoracolumbar stiffness, aggravated by prolonged sitting and standing and temporarily relieved by rest and stretching. Clinical examination identified lumbar hyperlordosis, anterior pelvic tilt, pelvic asymmetry, restricted hip extension, suspected iliopsoas dysfunction, reduced thoracolumbar fascial glide, and three positive provocation tests from a five-test sacroiliac-joint cluster. Neurological examination was normal, and no red-flag features were identified. Discussion: Treatment was delivered over 3 weeks in two phases. Phase 1 included moist heat, muscle-energy-based post-isometric relaxation for the iliopsoas, diaphragmatic breathing, remote soft-tissue treatment of the calf region within a superficial back-line framework, local fascial manipulation, and adjunctive electrotherapy. Phase 2 incorporated progressive distal-to-proximal strengthening and lumbopelvic integration. The Numeric Pain Rating Scale score decreased from 6/10 to 3.25/10, the Oswestry Disability Index score decreased from 35.5% to 22.2%, the Short Form-36 physical component score increased from 28.75 to 70.5, and the Global Rating of Change score was +6. No adverse events were reported. Conclusion: The case describes an improvement in pain, disability, self-reported physical health, and selected mobility measures after a multimodal physiotherapy program incorporating superficial myofascial-line techniques and progressive exercise.