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Title: Shorter lumbar paraspinal fascia Is associated with high intensity low back pain and disability.
Epworth Authors: O'Sullivan, Richard
Other Authors: Ranger, Tom
Teichtahl, Andrew
Cicuttini, Flavia
Wang, Yuanyuan
Wluka, Anita
Jones, Graeme
Urquhart, Donna
Keywords: Thoracolumbar Fascia
Low Back Pain
Muscle Ischemia
Chronic Pain Grade Scale
Lumbar Paraspinal Fascia
Structural Abnormalities
Pain Experience
MRI Department, Healthcare Imaging Services, Epworth HealthCare, Victoria, Australia
Issue Date: Apr-2016
Publisher: LWW
Citation: Spine, 41(8), E489-E493.
Abstract: STUDY DESIGN: A cross-sectional, community-based study. OBJECTIVE: The aim of this study was to investigate the relationship between structural features of the thoracolumbar fascia and low back pain and disability. SUMMARY OF BACKGROUND DATA: The thoracolumbar fascia plays a role in stabilization of the spine by transmitting tension from the spinal and abdominal musculature to the vertebrae. It has been hypothesized that the fascia is associated with low back pain through the development of increased pressure in the paraspinal compartment, which leads to muscle ischemia. METHODS: Seventy-two participants from a community-based study of musculoskeletal health underwent Magnetic Resonance Imaging from the T12 vertebral body to the sacrum. The length of the paraspinal fascia and cross-sectional area of the paraspinal compartment were quantitatively measured from axial images at the level of the transverse processes and the Chronic Pain Grade Scale was used to assess low back pain intensity and disability. RESULTS: A shorter length of fascia around the parapsinal compartment was significantly associated with high intensity low back pain and/or disability, after adjusting for age, gender, and body mass index [right odds ratio (OR) 1.9, 95% CI 0.99-3.8, P = 0.05; left OR 2.6, 95% CI 1.2 to 5.6, P = 0.01). Further adjustment for the cross-sectional area of the compartment strengthened the associations between fascial length and low back pain/or disability (right OR 8.9, 95% CI 1.9-40.9, P = 0.005; left OR 9.6, 95% CI 1.2-42.9, P = 0.003). CONCLUSION: This study has demonstrated that a shorter lumbar paraspinal fascia is associated with high intensity low back pain and/or disability among community-based adults. Although cohort studies are needed, these results suggest that structural features of the fascia may play a role in high levels of low back pain and disability. LEVEL OF EVIDENCE: 3.
DOI: 10.1097/BRS.0000000000001276
PubMed URL:
ISSN: 0362-2436
Journal Title: Spine
Type: Journal Article
Affiliated Organisations: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, Australia.
Baker IDI Heart and Diabetes Institute, Commercial Road, Melbourne, VIC, Australia.
Department of Medicine, Central Clinical School, Monash University, Melbourne, VIC, Australia.
Menzies Research Institute, Hobart, Tasmania, Australia.
Type of Clinical Study or Trial: Cross-Sectional Study
Appears in Collections:Diagnostic Services
Pain Management

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