Positional Release Technique Versus Stretching Exercises In Patients With Chronic Non-Specific Low Back Pain

Low back pain (LBP) is considered one of the most prevalent and debilitating musculoskeletal conditions that affects the majority of the general population. It is the most commonly reported complaint area in musculoskeletal conditions, leading to pain and a reduction in overall life quality. Low back pain is pain in the region between the 12th rib and the inferior gluteal fold and is a musculoskeletal system problem that is common in society, mostly caused by nonspecific causes and leads to disability.

Low Back Pain is present in developed countries as well as developing ones, but presents different issues in both: in developed countries, the impact and burden of Non-Specific Low Back Pain is placed on the healthcare and social system first. In contrast, in developing countries, the burden is predominantly placed on the people impacted by low back pain and their support systems.

Nonspecific low back pain is defined as the pain where no specific pathoanatomical cause can be identified and is the most common type of low back pain. A total of 90% of low back pain lacks identifiable pathology and is termed 'non-specific' low back pain (NSLBP). Depending on the duration of the pain, acute low back pain is defined as the pain persisting for less than 06 weeks, Sub-acute Non Specific Low Back Pain refers to pain that lasts between six weeks and three months and chronic non-specific low back pain is the pain when it lasts for more than 12 weeks. Low back pain often becomes chronic, and if non-specific low back pain lasts more than 3 months, it is called chronic non-specific low back pain. Many people with low back pain will experience resolution within 6 weeks of onset. However, two-thirds of people with low back pain report pain at 3 months and 12 months.

Chronic Low Back Pain is a widespread issue that affects many people's daily lives and work abilities. This research compares the Positional Release Technique and Stretching Exercises with standard physical therapy to see which treatment better reduces pain, improves range of motion and decreases disability. The goal of this research is to provide physical therapists with clear evidence on the most effective treatment for CNSLBP, focusing on Iliopsoas, Quadratus Lumborum and Hamstrings Muscle. By identifying the best techniques, this study aims to equip physical therapists with new methods to enhance patient care which, in turn, will aid the healthcare system in providing more effective care.

Inclusion criteria

• Male or Female Gender
• 18 - 45 years of age
• Back Pain with the duration longer than 12 weeks.
• Numeric Rating Scale (NRS) score of 3-7/10
• Oswestry Disability Index score of 20-60
• Minimum 20 degrees of flexion at knee while performing active knee extension test
• Positive Modified Thomas Test
• Participations with Lumbar Pain and Pain in the attachments of Quadratus Lumborum Muscle (iliac crest and lower ribs) or pain localized para spinally or restriction in motion of lumbar due to tightness of Quadratus Lumborum Muscle

Exclusion criteria

• Serious spinal disorders, such as fractures
• History of trauma or Previous Spinal Surgery
• Spine osteoarthritis, Spinal Canal Stenosis and Spondylolistheses
• Any neurological symptoms involving Prolapsed Intervertebral Disc, Radiculopathy or presence of root symptoms (e.g. Sciatica and Cauda Equina Syndrome)
• Any systemic disease like Rheumatoid Arthritis, Ankylosing Spondylitis
• Pregnancy, Cancer or Malignancy
• Altered Sensation and Deep Tendon Reflex