Fascia Therapy Offers New Perspectives on Chronic Low Back Pain
Low back pain is one of the most common health complaints in the Netherlands. Often, no clear structural cause can be identified, while the pain can significantly limit daily functioning. Human movement scientist Robbert van Amstel investigated a widely used but, until now, poorly substantiated treatment approach: Fascia Focused Interventions (FFIs). His results show that this approach can indeed have a positive effect on pain, mobility, and quality of life.
FFIs focus on fascia, the connective tissue that links skin, muscles, and bones. In physiotherapy, these treatments have been applied for years through mechanical stimuli such as pressure, stretching, and skin displacement. For a long time, however, it was unclear how these interventions actually work and what benefits they offer for patients with low back pain. Van Amstel aimed to close this knowledge gap.
His research shows that fascia plays a larger role in low back pain than is often assumed. By deliberately moving the skin, the underlying fascial structures move along with it. This can increase range of motion and reduce pain. Notably, this effect is measurable and occurs relatively quickly. A simple test, the so-called DAMT test, also helps therapists determine the direction of skin displacement that is most effective for an individual patient.
Part of a Standard Treatment Protocol
The greatest benefit is achieved when fascia-focused interventions are not applied in isolation but are incorporated into a standard treatment protocol. In the so-called 4xT protocol—testing, treating, taping, and exercise therapy—patients experience greater improvement than with exercise therapy alone. They move more easily, experience less pain, and report a better quality of life.
Low back pain leads each year to high healthcare costs, work absenteeism, and loss of quality of life. Van Amstel’s research provides physiotherapists with practical tools to apply treatments in a more targeted and personalized way. This can result in faster functional recovery and potentially a reduced reliance on pain medication or invasive procedures.
In the longer term, these insights may contribute to better substantiated, non-pharmacological treatment guidelines for low back pain. In this way, the research aligns with a broader shift in healthcare: away from symptom management and toward a stronger focus on movement, functioning, and quality of life.
More information on the thesis