Stretching has an extraordinary reputation for being good for aches and pains, but it’s not clear that stretching deserves this honour.
Stretching as therapy mostly rides on the coat-tails of stretching’s indomitable popularity for other purposes, especially the nearly universally accepted idea that flexibility is a pillar of wellness and fitness, on par with strength and endurance. Unfortunately, that claim does not hold up to scientific scrutiny. All common ideas about the benefits of stretching have been shot down by research over the last twenty twenty years.
See Quite a Stretch for a bird’s eye view of the whole topic of stretching and the major myths about it. This article focusses just on the idea that it’s good for pain — an idea that is a bit dubious when you consider stretching’s failure to deliver any other clear benefits.
But if stiffness is like an itch, stretching is how we want to scratch it! And the symptom of stiffness is thoroughly tangled up with chronic pain. The pleasant sensations of stretching seem directly relevant to the symptom of stiffness, like ice on a burn. It feels inherently valuable to people, and I am not knocking “pleasure”!
But not everything that feels pleasant is actually therapeutic, and there are many, many kinds of pain. Even if stretching is good for some of them, it probably isn’t good for all or even most of them.
So what does stretching work for? Anything? And if so, why? I will have some good things to say about it, but there’s also plenty of debunking ahead.
For the closely related topic of stretching as a part of rehab from sports injuries, see 5 Main Reasons Athletes Stretch… All Flawed.
The anecdotal evidence that stretching “works” for miscellaneous body pain and stiff and aching muscles is substantial. (So is the anecdotal evidence that it can backfire.) There is also some scientific evidence suggesting that stretching is helpful for common stubborn pain problems, such as neck and back pain,12 but it’s also a complicated, incomplete, underwhelming mess, and there are also popular stretching practices that are clearly a waste of time. One of the best examples is the idea that tight hamstrings cause back pain, and therefore stretching them is good back pain therapy. But they really don’t, and it’s really not.3 And yet that belief probably accounts for at least 50% of all the stretching people do for back pain!
In general, stretching doesn’t seem to come close to “curing” anyone, but darned if it doesn’t also sometimes seem “take the edge off” enough to make it worth trying. So people in pain stretch, and sometimes they feel better. A little bit. For a while.
People who feel stiff and tight usually assume their range of motion is limited by literally short muscles, but this is rarely the case, despite how it feels. Stiffness isn’t the same as being inflexible; they aren’t even really related.
There are many possible causes of soreness and stiffness that stretching has little to do with: sensitization, and positional cervical cord compression and multiple level radiculopathy, vitamin D and magnesium deficiency, and non-obvious entrapment of nerves (neuropathy) and bloods vessels (claudication). Several hard-to-diagnose diseases can involve long-term excessive aches and pains as a major symptom, such as the hypermobility disorders, facioscapulohumeral muscular dystrophy (FSHD), and multiple sclerosis. And then there’s drug side effects, too!4
That is just a sampling; all of these and more are summarized in 34 Surprising Causes of Pain. If you have pain from any of these sources, stretching is quite unlikely to help. In some cases, it might be useful for symptom control, at best.
Of course, there could be reasons why stretching is good for pain that we don’t understand, or are only just barely starting to understand. In the next sections, I’ll get into some of the causes of stiffness that stretching might be more relevant to: inflammation, trigger points, and contracture. But — spoiler alert — there’s literally not one clear promising example of stretching as effective medicine for anything painful. Not one.
Why do we so clearly get stiffer as we age? Even in people who have nothing in particular wrong with them, none of the many causes of aches and pains mentioned above?
If there’s one thing most responsible for the feeling of needing to stretch, it’s probably the most common cause of aches and pains: “inflammaging.” Chronic low-grade inflammation that gradually escalates over the years, for all kinds of poorly understood reasons.5 This kind of stiffness is basically a form of mild pain that limits range of motion basically by making it uncomfortable. Our brains are more reluctant to allow free, quick movement of sore tissues. Stiffness is probably mainly a form of inhibition, then.
Unfortunately, systemic inflammation cannot be diagnosed or treated reliably by any means: it is simply too complicated and mysterious. Nevertheless, it is a trendy bogeyman, and allegedly anti-inflammatory diets in particular are extremely popular. But the best defense is simply to be as fit and healthy as possible.
And stretching? That seems like a long shot. But it’s worth discussing, at least.
Stretch your inflammation away?
A 2016 study produced one scrap of evidence that stretching reduces inflammation in connective tissues.6 It’s not clear how much “inflammation in connective tissue” is related to inflammaging — maybe none, maybe lots — but obviously there could be a connection.
We do also have some relevant evidence that inflamed connective tissue is associated with back pain,7 which is of course the epicentre of stiffness as we age (although back pain actually backs off quite a bit on the far side of middle-age).
That evidence is all there is, and it’s too scanty to trust yet. In fact, I am confident that these isolated research clues are probably misleading, and I don’t really buy that stretching reduces inflammation any more than I believe that massage reduces inflammation (a popular idea based on one over-hyped study8). But let’s keep our minds open.
If stretching does help some inflammation resolve, obviously that would be good for us. It wouldn’t even have to be a large or consistent effect (neither are the benefits of pain meds). “Taking the edge off” sometimes would be enough to explain the reputation stretching has for relieving stiffness and soreness.
Chances are strong that inflammaging is a steamroller that stretching cannot really touch, however. There are several high plausible mechanisms for inflammaging that are quite unlikely to be affected by stretching. The best hope is that stretching is somehow mildly anti-inflammatory, regardless of what caused the inflammation, but it’s more likely that fitness is much more “anti-inflammatory” than stretching specifically. Practically any functional stimulation of the same tissue — not just stretching — might have the same modest anti-inflammatory effect.
There is one kind of soreness that is common and might be responsive to stretching: the stiffness and aching associated with those sensitive spots in muscles commonly known as “muscle knots” or trigger points.
The story goes like this: trigger points are isolated regions of contracted muscle fibres, basically micro cramps. If that’s how they actually work, then stretching might be a viable treatment method. Unfortunately, how they work is highly debatable, and basically unknown.
Stretching as a treatment for trigger points has some expert endorsements. In the weighty text Muscle Pain, researchers Dr. David Simons and Dr. Siegfried Mense wrote that stretching “by almost any means is beneficial.” This depends on chain of assumptions and theories about how trigger points work: the micro-cramp is metabolically exhausting, like an engine revving in the red, producing waste metabolites that pollute and irritate the surrounding tissues, causing pain and more contraction. In theory, a trigger point cannot burn fuel if it is fully elongated, which would give the energy crisis a chance to abate — a vicious cycle breaker.
If they are right, then stretching works about the same way that stretching out a calf cramp works: you win the tug-of-war with spasming muscle, just on a smaller scale. This sounds great on paper, but there are several major problems in both theory and practice. Simons and Mense also emphasize that it has “not been firmly established” that stretching trigger points is helpful, and that stretch works primarily for “newly activated, single-muscle” trigger points … leaving out a lot of trigger points that are serious problems. There are many circumstances in which you cannot realistically hope to win a tug-of-war with a strong one, because it would be too anatomically awkward and/or too painful.
How can we pull apart a powerful contraction knot — a tiny segment of muscle fibres in full spasm — with anything less than pliers, a vice, and a glass of bourbon? We almost certainly do not have the leverage or pain tolerance required, especially if the muscle fights back with a defensive contraction (which may account for the cases that backfire). That trigger point is like a knot in a bungie cord: all we’re going to do is stretch the hell out of the bungie cord on either side of the knot. If it works at all, it probably mostly only works on the milder cases that don’t matter much in the first place.
And then there’s the possibility that Simons and Mense were just wrong, and a trigger point is not like a tiny cramp at all. If there is no metabolic “revving,” no energy crisis to interrupt by pulling muscle proteins apart like kids fighting on a playground, then it’s back to the drawing board: either stretching doesn’t work at all, or we just have no idea how it works. Which is possible.
This topic is covered in much greater detail (about 10x the length of this section) in my trigger points book.
Muscle and tendon, although they are distinct tissues, blend together quite seamlessly. Much of what we think of as mucle is an extension of tendinous tissue, and vice versa. It’s impossible to draw a line where tendon stops and muscle starts, and if stretching doesn’t do much to muscles, it probably doesn’t do much to tendons either.
And so most likely a positive effect of stretching on tendons is minimal or nil. Digging a little deeper …
In general, tissues are stimulated to growth and repair by the same forces that they normally have to deal with (and also the same forces that occasionally overload and overwhelm them and cause overuse injury or trauma). That stimulus is dished up far more efficiently and thoroughly by normal (and athletic) activity than by any isolated deliberate exercise therapy.
Cells inside of tendons generate collagenous fibres and absorb others as needed in response to stresses, constantly remodelling and tweaking the tendon so that it is optimized to cope with the actual stresses it encounters all day, every day. (Organisms always act on the assumption that the immediate future will probably be similar to the immediate past — that doesn’t always work out, but it’s a pretty good rule of thumb.)
However, tendons are quite static compared to other tissues, and remodelling is slow and “conservative” — they don’t do it quickly. Even a very strong stretch to a tendon constitutes an extremely brief input of stimulus relative to the context of an entire day or week of normal usage of the tendon. It probably takes months of regular, consistent, and significant new stresses for a tendon to change.
For comparison, consider how bone remodels — and bone is much more dynamic and responsive than tendons are. If bones are subjected to strong new stresses, they will change, slowly but steadily getting thicker and tougher in just the right way to cope with that stress. But it takes a lot! Now, how much do you suppose you could influence that process by deliberately applying a force to the bone? Even a fairly heroic twenty-minute application per day — far more than anyone would ever bother stretching a single tendon, or pair of tendons? And even if it could work, what are the chances that the deliberate application of force would be a good enough “simulation” of natural biomechanical stresses that it would elicit the desired, relevant adaptation? A simulation might be good enough in principle in some cases, but in general it’s just not going really be very much like the stresses that the tendon actually has to deal with in the real world — and therefore fundamentally inefficient way of preparing for it! If it works at all.
About alignment … the specific notion that tendon stretching will “align” its fibres is a particularly dubious and overly optimistic concept. Tendons are well nigh impervious, rupture only with extreme forces (and/or when already compromised), and change only in response to long term “just right” overloading. It’s relevant to understand that they are so tough that they are the strongest link in the chain, and in many cases they will tear away from their moorings on bone (avulsion fracture) before the “rope” breaks. For a mere stretch, collagen fibres don’t line up obediently any more than they already are — and tendons have impressively well-aligned microscopic orderliness to begin with.
It’s also extremely important to note that study after study after study has shown no injury prevention benefit to stretching … and that includes tendon injuries. Tendons are not getting injured any less frequently in people who stretch a lot. If you want to reduce the chances of your tendons rupturing, then the way to do it is to expose them to a bunch of activities. Push the envelope just a little: enough that they are challenged, but not brutalized! Just the right amount of stimulation.
If stretching is mostly irrelevant to pain and injury, why is it that I feel like I have to stretch or I’m going to seize up like an old piece of leather? Why do I have this compulsion to stretch, and why does it feel so good, if it’s not actually doing anything? Why is this true for so many of us?
Because it is probably actually doing something! It’s just probably not doing what you thought it was doing. And we don’t really know for sure what it is doing. If we are intellectually honest, we simply have to admit that.
People routinely report that stretching feels good, that it reduces muscle soreness, or that they feel a strong urge to stretch. And I’m one of them. I have a stretching habit because it feels good, and because it feels like I’m going to “seize up” if I don’t. In particular, I stretch my hamstrings regularly and strongly, and it feels as pleasantly essential to my well-being as slipping into a hot bath — but the exact nature of the benefits are completely unclear to me, and I suspect it’s about as medically useful as a back scratch.
It’s probably a stew of genuine but mysterious and subtle physiological benefits — like the heart rate regulatory effect noted in the last section — plus almost certainly some good placebo, too. I was raised on stretching. Despite my doubt about the conventional wisdom, I tend to emotionally “believe” in stretching just like everyone else — it’s deep in our culture, and, since stretching feels good, it’s easy for my mind to jump to the conclusion that it must be good. But of course that’s not really helpful at all — lots of things feel good without having any clear physiological benefits. Stretching might be like scratching: an undeniably strong impulse, but with almost no relevance to athletic performance or overall health.
I just don’t know. And based on the research to date, no one else does either.
If people believed that feeling good was the only thing that stretching was good for, most people — especially the athletes — would drop it from their exercise routine immediately. Most of us have better things to do. However, if someone firmly declared, “I stretch just to feel good,” I would applaud and say, “Hallelujah! That is an excellent reason to stretch! And one of the few that I can defend!”
And, then again, there may actually be real physiological benefits to stretching — just not the usual ones that get tossed around.
Is food an effective therapy because it tastes good?
Is music an effective therapy because it sounds good?
Essentially every pleasant sensation and experience has therapeutic qualities. These therapeutic qualities are not unimportant, but they’re not the same thing as an effective therapy. There’s a good reason why your physical therapist never prescribes ice cream. Here’s the last big stretching mystery I’d like to cover: how can stretching be so pleasant without (apparently) doing much measurable good? Look at this pattern:
- Stretching feels great … but it’s over-rated and nowhere near as medically or athletically useful as most people think.
- Massage feels even better … but its effects on pain are notoriously mild and fleeting.
- Chiropractic “adjustments” can feel scrumptious, even addictive, especially in that cinder-block-rigid area between the shoulder blades … but in most cases you’ll be craving a re-do before long (which makes for a lovely business model for chiropractors).
The pattern is that of being “relieved” instead of “fixed.” Over many years of thinking about pain and therapy, it has been a stubborn mystery to me why these things can feel so good — really, really good — without making any large or lasting difference to most painful problems, most of the time.
Feeling good without working all that well causes no end of confusion and trouble. Wonderful and profound sensations are largely responsible for an epidemic of excessive optimism about their healing powers. It’s understandable that we would expect something that feels that good to work well, but a lot of testing has shown over and over again that stretching, massage and chiropractic are not exactly saving the world from its aches and pains.
It’s not hard to explain how something might feel good without curing pain. Sex feels great, but it does not cure pain. Back scratches, chocolate cake, sunshine, and hot baths: all wonderful, all mostly powerless to cure pain.
But stretching is where the gap between how it feels and how well it works is the most glaring, the best feeling but most useless of “treatments.” I’ve already mentioned that I do stretch regularly because I like it, but that doesn’t quite cover it: I actually stretch for pleasure almost every single day. I’m as inflexible and prone to aches and pains as ever, and I’ve never been able to justify the habit with anything except, “Because it feels good, dammit.” And that’s fine.
But why does it feel that good? “It’s stimulating” just doesn’t cut it. I can give a specific reason why each of the delicious things above feel so good. But stretching? I just don’t get it.
And then one day — while I was stretching, of course — I had an epiphany: stretching doesn’t just feel like scratching an itch, maybe it’s actually scratching an itch. A deep itch. In my experience, stretching feels best when I am sore from working out — which only deepens the mystery. Why would it feel so pleasant to pull on soft tissues that are incredibly sore?
That soreness is like an internal “rash” or any skin irritation. And we feel an incredible compulsion to scratch rashes, mosquito bites and other itchy, irritated things. Consider the mosquito bite: scratching it is certainly not going to “treat” it, and we know it. But the temporary relief of scratching is so great it almost transcends pleasure and degenerates into a nasty compulsion. As many pleasures do.
Could it be that exercise-induced soreness is kind of like a minor internal “rash”? And that stretching is just about as close as we can get to “scratching” it? To get a little fleeting relief? This is the best analogy I’ve come up with yet to describe how stretching feels to me.
There may be many reasons why stretching feels good without being particularly helpful, but this makes some serious sense to me. It’s specific and plausible. It achieves the difficult trick of simultaneously accounting for both the unusually pleasant sensation and the more or less total lack of any meaningful effect. And it nicely fits the way I like stretch best when my muscles feel the worst. And it makes even more sense if you extend the metaphor of the itch to include the even more common sensations of being stuck or stagnant, which I’ve written about in the past (guest posting for Todd Hargrove’s excellent blog, see The Bamboo Cage).
I have often said that stretching and other relieving sensations of massage or spinal adjustment feel “like” scratching an itch. But I never went that extra step and considered that maybe they feel like that because, in a way, they actually are — because we can have genuine internal “itches,” vague sensory annoyances … and very limited and indirect ways of scratching them.
“Contracture” is the unlovely process of muscle and other soft tissues seizing up in response to neurological problems or prolonged immobilization. Your face can’t really “freeze like that” as your mother warned you, but if you could make an ugly face long enough — weeks — eventually contracture really would set in. This is pathology, mind. The tissue changes. For the worse.
Most people probably assume that long, intense stretches must be an effective prevention/treatment for contracture, perhaps the only viable option. It is not an assumption held with much conviction, but stretching always gets the benefit of the doubt, whether it deserves it or not, and it seems to make sense that stretching would be a cure for contracture.
Common sense fails again. As it so often does. The Cochrane Collaboration published a review of static stretch for the treatment and prevention of contractures.9 The verdict? Thumbs way down. Based on “high quality evidence” they concluded that “stretch is not effective for the treatment and prevention of contractures.” I’m shocked. Shocked, I say!
Treatments are usually more obviously valuable to those who need them more. For example, the effect of acetaminophen is more obvious to someone with a headache. This very basic principle doesn’t always apply, but it usually does. This evidence shows that stretch does not meaningfully help even for a condition where the need for tissue elongation is dramatic.
So this is (yet another) great example of a “technical” reason to stretch that many or most people would assume to be effective. But no — probably not static stretch, anyway.10
Pathologically seized up tissue cannot be meaningfully elongated. So what’s happening when healthy people seem to get flexible?
About Paul Ingraham
I am a science writer in Vancouver, Canada. I was a Registered Massage Therapist for a decade and the assistant editor of ScienceBasedMedicine.org for several years. I’ve had many injuries as a runner and ultimate player, and I’ve been a chronic pain patient myself since 2015. Full bio. See you on Facebook or Twitter.
Specifically about stretching:
- Stretching Injury — How I almost ripped my own head off! A cautionary tale about the risks of injury while stretching
- A Stretching Experiment — What happens when you stretch your hamstrings intensely for several minutes a day in a steam room?
- IT Band Stretching Does Not Work — Stretching the iliotibial band is a popular idea, but it’s very hard to do it right, and it’s probably not worth it
- 5 Main Reasons Athletes Stretch… All Flawed — Stretching science shows that it doesn't do most of what we hope it does
- Stretching for Flexibility — You can increase your flexibility by stretching, for whatever it’s worth… but what is it worth?
- Mobilize! — Dynamic joint mobility drills are an alternative to stretching that “massage with movement”
- Quite a Stretch — Stretching science has shown that this extremely popular form of exercise has almost no measurable benefits
- The Unstretchables — Eleven muscles you can’t actually stretch hard (but wish you could)
- Does Posture Correction Matter? — Posture correction strategies and exercises … and some reasons not to care or bother
- Why Do Muscles Feel Stiff and Tight? — Maybe your range of motion is actually limited, or maybe it just feels that way
- Post-Exercise, Delayed-Onset Muscle Soreness — The biology & treatment of “muscle fever,” the deep muscle soreness that surges 24-48 hours after an unfamiliar workout intensity
- The Tyranny of Yoga, Meditation, and Mindfulness — Do you really need to try them? How much do they matter for recovery from conditions like low back pain?
- Strength Training for Pain & Injury Rehab — Why building muscle is easier, better, and more important than you thought, and its role in recovering from injuries and chronic pain
- Pain is Weird — Pain science reveals a volatile, misleading sensation that is often more than just a symptom, and sometimes worse than whatever started it
- The 3 Basic Types of Pain — Nociceptive, neuropathic, and “other” (and then some more)
- 34 Surprising Causes of Pain — Trying to understand pain when there is no obvious explanation
This article was originally part of a much larger article dating back to the first version in August 2000. Twenty years later, I split that big ol’ article up in August 2020, giving this sub-topic new life on its own page.
Aug 7, 2020 — Editing: Content is like-new after being extracted from stretching mega-article and converted into a stand-alone article on the sub-topic of stretching as a treatment for pain.
January — Science update: Added an important example, stretching the hamstrings for back pain, with a few relevant references. [Updated section: Stretching as therapy for miscellaneous pain and stiffness.]
2019 — New section: No notes. Just a new chapter. [Updated section: Stretching, inflammation, and aging.]
2018 — Minor addition: “Endorphins” now have a sidebar. [Updated section: Stretching does feel good, and maybe that is a kind of pain-killer.]
2018 — Expanded: Added more the nature of soreness and stiffness, and the relevance of stretching (or lack thereof). [Updated section: Stretching as therapy for miscellaneous pain and stiffness.]
2017 — Science update: Cited and discussed implications of anti-inflammatory effect reported by Berrueta et al. [Updated section: Stretching as therapy for miscellaneous pain and stiffness.]
2016 — Rewritten: Complex and thorough modernization and other improvements. [Updated section: Stretching as therapy for miscellaneous pain and stiffness.]
- Ylinen J, Kautiainen H, Wiren K, Hakkinen A. Stretching exercises vs manual therapy in treatment of chronic neck pain: a randomized, controlled cross-over trial. J Rehabil Med. 2007;39(2):126–132. PubMed #17351694 ❐
This examiner-blinded randomized cross-over trial of 125 patients found pretty promising benefits to both stretching exercises and “manual therapy” for a month, and the researchers concluded that “low-cost stretching exercises can be recommended in the first instance as an appropriate therapy intervention to relieve pain, at least in the short-term.” However, there are several reasons not to get too excited about the significance of this study, perhaps the most important of which is simply that showing some improvement over 4 weeks is hardly an impressive therapeutic accomplishment, and if the study had included a control group it might well have revealed that the “therapeutic” effects weren’t much different than the natural course of the condition — i.e. everyone might have gotten better, with and without therapy of any kind.
- Sherman KJ, Cherkin DC, Wellman RD, et al. A Randomized Trial Comparing Yoga, Stretching, and a Self-care Book for Chronic Low Back Pain. Arch Intern Med. 2011 Oct. PubMed #22025101 ❐
This experiment compared the effects of yoga, a normal stretching class, and an educational booklet on chronic low back pain. The primary findings were that both yoga and stretching seemed to be modestly effective, but neither was better than the other. Back in 2005, the same authors got similar results comparing yoga to conventional therapeutic exercise.
The research has been widely reported as “stretching and yoga work,” with a few writers emphasizing that yoga was no better. However, I haven’t seen anyone report that both stretching and yoga are equally damned here with faint praise, and quite possibly illusory praise: the effect size was modest, just 2.5 points on a scale of 11, and some or all that effect may well be attributable to bias and frustrebo (frustrated placebo) caused by a lack of blinding. Subjects deprived of either a lovely stretching or yoga experience may have reported a more negative experience.
I analyze this study in greater detail in my advanced tutorial, Complete Guide to Low Back Pain
- This is a complex topic I cover in detail in my back pain book. Short version: even simple hamstring stretching definitely makes hamstrings more extensible and improves ROM (Marshall et al), but there’s no correlation between back pain and how the hamstrings are behaving in the first place. A 2019 scientific review (Hori et al) was inconclusive “due to very low quality of evidence.” A 2017 review (Sadler et al) was a little more reckless, and went with a conclusion based on just a handful of studies, including some that had been deliberately ignored by the more recent review, and they reported a 4% greater chance of back pain in people with inflexible hammies, with is either trivial or just untrue because it’s based on such weak data. For an example of a simple negative trial, see Marshall et al: they reported “no [hamstring] relationship to actual disability.”
- Some drugs are notorious for causing joint and/or muscle pain as a side effect. (Other kinds of pain are possible too, but are usually more distinctive and readily identified as a drug side effect. But joint and muscle pain are often mistaken for musculoskeletal trouble, and no one suspects the drug.) The usual suspects are the statins (for lowering cholesterol), bisphosphonates (for osteoporosis and Paget’s disease), fluoroquinolones (a class of antibiotics with an extraordinary range of nasty side effects, most notoriously tendinitis), the retinoids (for skin conditions, like Accutane for acne), and Trintellix (an antidepressant). Withdrawal from benzodiazapenes (Valium, Ativan, Xanax, etc) can be extremely uncomfortable and painful; unaware of the risks, many people stop taking them carelessly and suffer quite a bit without ever knowing why. For more detail on some of these, see 34 Surprising Causes of Pain.
How do we get into this mess? Inflammaging correlates with poor fitness and obesity (metabolic syndrome, the biological precursor to diabetes and heart disease). And that, in turn is linked to chronic psychological stress (and of course biological stresses too, like smoking and sleep deprivation). And then there are several other unproven but plausible reasons why inflammation escalates as we age, such as the accumulation of permanent minor infections, lasting collateral damage from past infections (essentially autoimmune disease and allergies that are too subtle or nonspecific to diagnose), and environmental poisons.For a much more thorough exploration of these possibilities, see Chronic, Subtle, Systemic Inflammation: One possible sneaky cause of puzzling chronic pain.
- Berrueta 2016, op. cit.
- Langevin HM, Stevens-Tuttle D, Fox JR, et al. Ultrasound evidence of altered lumbar connective tissue structure in human subjects with chronic low back pain. BMC Musculoskelet Disord. 2009 Dec;10:151. PubMed #19958536 ❐ PainSci #53554 ❐
Researchers measured the thickness of lumbar connective tissues with ultrasound in 60 chronic low back pain patients and 47 health people. The fascia was about 25% thicker in people with back pain, which is quite a bit, and a surprising finding with potentially major — but unknown — clinical significance. The authors suggest that it could be related to “genetic factors, abnormal movement patterns and chronic inflammation.”
This observation has not been reproduced by other researchers, but a follow-up study in 2011 examined the flexibility of the same tissue, and found it was about 20% less in back pain patients: see Langevin for more commentary on the implications of both studies.
- Ingraham. Massage Does Not Reduce Inflammation: The making of a new massage myth from a high-tech study of muscle samples after intense exercise. ❐ PainScience.com. 4166 words.
- Harvey LA, Katalinic OM, Herbert RD, et al. Stretch for the treatment and prevention of contractures. Cochrane Database Syst Rev. 2017 Jan;1:CD007455. PubMed #28146605 ❐ PainSci #52742 ❐
- Perhaps there are other methods of stretching that do work for contracture, but the average person has no idea what those are, and therapists scatter in every direction on this point, failing to agree on which “other method” works because there is no evidence base for it — just a whole lot of guessing.