Effectiveness of the Graston Technique for low back pain and thoracic spinal pain: a systematic review and meta-analysis

Abstract

OBJECTIVES: Low back pain (LBP) and thoracic spinal pain are significant global health burdens, and the Graston Technique (GT), a form of instrument-assisted soft tissue mobilization (IASTM), has gained popularity as a treatment option. This systematic review and meta-analysis aim to evaluate the effectiveness of GT for reducing pain and preventing disability in individuals with LBP and thoracic spinal pain. METHODS: We conducted a comprehensive literature search across PubMed, EMBASE, Web of Science, Scopus, and the Cochrane Library, identifying four eligible studies from inception to August 2024. Both randomized and non-randomized controlled trials were included. The primary outcomes were changes in Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores. Quantitative data were analyzed using meta-analysis, and qualitative synthesis was conducted for secondary outcomes. Statistical analyses were conducted using Review Manager (RevMan) version 5.4. RESULTS: The pooled analysis showed a significant reduction in VAS scores when comparing GT to placebo controls (Mean difference = -1.45, 95%CI [-2.24, -0.66]), suggesting that GT may effectively reduce pain. However, no significant difference was observed when compared to active interventions. The meta-analysis revealed no significant improvement in ODI scores with GT compared to placebo. Qualitative synthesis indicated potential benefits in range of motion, flexibility, proprioception, and quality of life. CONCLUSION: The GT may reduce spinal pain, particularly compared to placebo. However, these preliminary results require confirmation from further studies as its impact on functional outcomes and superiority over other treatments remain uncertain. Further high-quality research is necessary to confirm these findings and establish GT's role in clinical practice.