Fascia-Focused Versus Conventional Physiotherapy for Chronic Low Back Pain and Comorbid Depression in Psychosomatic Inpatients

Background: Chronic low back pain (CLBP) and depression often co-occur. This study compared a fascia-focused physiotherapeutic program with a conventional physiotherapeutic and relaxation-based program in psychosomatic inpatients with CLBP and comorbid depression. Methods: In this exploratory quasi-randomized study, 41 inpatients were allocated to a fascia-focused intervention group (n = 23) or a conventional active control group (n = 18). Over six weeks, the intervention group received Bowen therapy and fascia circuit training, whereas the control group received progressive muscle relaxation and strength circuit training. Outcomes were assessed at baseline and after rehabilitation. NRS pain intensity and BDI-II depressive symptom severity were the main clinically relevant outcomes; spinal function, tissue stiffness, pressure pain threshold, and craniovertebral angle were secondary or exploratory outcomes. Results: Both groups improved over time in pain intensity and depressive symptom severity. NRS scores decreased by 3.21 ± 2.61 points in the fascia-focused group and by 2.17 ± 2.34 points in the control group; BDI-II scores decreased by 9.30 ± 13.42 and 7.22 ± 8.57 points, respectively. Repeated-measures ANOVA confirmed significant time effects for NRS and BDI-II, with no significant group differences or time × group interactions. Significant time effects were also observed for thoracic tissue stiffness, lumbar and pelvic posture, thoracic and lumbar mobility, and pelvic stability. Conclusions: Fascia-focused and conventional physiotherapy showed similar observed effects in this exploratory quasi-randomized study. The absence of significant between-group differences should be interpreted cautiously because the study was not designed or powered to establish formal equivalence.