Manual Therapy Approaches in Quadratus Lumborum Syndrome: Comparing Muscle Energy Technique (MET) versus Myofascial Release (MFR) with Transcutaneous Electrical Nerve Stimulation

Ruchita Chandrakant Kyadari, Veena J., Dr. Yatish R.

Abstract: Background: Quadratus Lumborum Syndrome (QLS) is one of the most widely seen yet underdiagnosed causes of low back pain in clinical practice. It arises from myofascial trigger points within the quadratus lumborum muscle, producing deep lumbar aching, restricted spinal movement, and considerable difficulty in performing routine daily activities. Manual therapy techniques such as Muscle Energy Technique (MET) and Myofascial Release (MFR) are increasingly applied in clinical management of this condition, yet direct comparative evidence remains limited. Objective: This study set out to evaluate and compare the clinical outcomes of MET and MFR, each administered alongside Transcutaneous Electrical Nerve Stimulation (TENS), in patients diagnosed with QLS. Methods: Sixty patients between 30 and 50 years of age, all diagnosed with QLS, were enrolled and randomly divided into two treatment groups of thirty each. Patients in Group A underwent MET sessions combined with TENS, while those in Group B received MFR combined with TENS. Both groups attended four treatment sessions every week over a period of two weeks. Pain sensitivity was evaluated using the Pressure Pain Threshold (PPT) measured with a digital algometer. Lumbar mobility was assessed through the Modified Schober?s Test for flexion and extension, and the Finger-to-Floor Distance (FFD) test for lateral flexion. Functional disability was quantified using the Roland-Morris Disability Questionnaire (RMQ). Paired t-tests were used for within-group comparisons, independent t-tests for between-group analysis, and Chi-square tests for nominal data, with statistical significance set at p < 0.05. Results: At the end of the intervention period, both groups recorded statistically significant improvements across all outcome parameters (p < 0.001). When the two groups were compared against each other, Group B consistently outperformed Group A on every measure. Lumbar flexion improved by 30.00% in Group B versus 14.69% in Group A (p = 0.00001). Extension improved by 29.08% versus 16.06% (p = 0.000237). Lateral flexion showed gains of 31.65% in Group B compared to 15.32% in Group A (p = 0.047). PPT increased by 48% in Group B and 33% in Group A (p = 0.0001). Disability scores on the RMQ reduced by 39.40% in Group B and 24.95% in Group A (p = 0.0007). Conclusion: Both treatment approaches produced meaningful clinical benefits when delivered over a two-week period. However, the combination of Myofascial Release with TENS resulted in greater reductions in pain, superior restoration of lumbar mobility across all planes, and more substantial improvement in functional ability. MFR combined with TENS is therefore recommended as the more effective physiotherapy strategy for managing Quadratus Lumborum Syndrome.

Keywords: Quadratus Lumborum Syndrome, Myofascial Pain Syndrome, Myofascial Release, Muscle Energy Technique, TENS, Pressure Pain Threshold, Lumbar Range of Motion, Roland-Morris Disability Questionnaire

How to Cite?: Ruchita Chandrakant Kyadari, Veena J., Dr. Yatish R., "Manual Therapy Approaches in Quadratus Lumborum Syndrome: Comparing Muscle Energy Technique (MET) versus Myofascial Release (MFR) with Transcutaneous Electrical Nerve Stimulation", Volume 15 Issue 7, July 2026, International Journal of Science and Research (IJSR), Pages: 100-106, https://www.ijsr.net/getabstract.php?paperid=SR26701135803, DOI: https://dx.doi.org/10.21275/SR26701135803

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