Multimodal approach for thoracolumbar fascia rehabilitation in non-specific low back pain: narrative review

Background
The thoracolumbar fascia (TLF) serves as a biomechanical anchor connecting the upper and lower extremities through the anterior and posterior oblique sling systems, thereby contributing to postural control, load transfer, and proprioception. Disruptions within these fascial networks are increasingly recognised as potential contributors to chronic non-specific low back pain (NSLBP), particularly in young adults.

Aims
This review investigates the anatomical and clinical significance of the thoracolumbar fascia (TLF) and its integrated sling systems in relation to non-specific low back pain (NSLBP).

Material and methods
This article systematically reviews literature published between 2000 and 2024 in order to highlight the biomechanical, nociceptive, and proprioceptive roles of the TLF and to evaluate clinical interventions targeting this structure, including myofascial release, transcutaneous electrical nerve stimulation (TENS), and Kinesiotaping.

Results
Emerging evidence suggests that these therapeutic modalities may provide short-term improvements in pain modulation and movement control. Despite growing research interest, the number of available randomized controlled trials (RCTs) remains limited, highlighting the need for further high-quality studies.

Conclusions
This review proposes a clinical rationale for adopting a multimodal therapeutic approach to improve treatment outcomes in NSLBP management by directly addressing dysfunction associated with the thoracolumbar fascia.