I recently obtained my Ph.D. in Biomedical Engineering from the Faculty of Medicine at the University of Montreal. This is the culmination of more than six years of research, using ultrasound to examine the thoracolumbar fascia (the fascia of the lower back) and exploring its relationship with non-specific low back pain, which has no clear cause. Here, I would like to report on what I discovered.

Until now, it was thought that the “tightening” of the fascia might be the cause of pain, but there were limited ways to objectively measure how the fascia actually moves inside the body. Therefore, in my research, I used ultrasound image analysis to quantify the movement of the fascial layers when the body moves, as well as their internal “microstructure.”

We found three main things.

First, compared to healthy individuals, the sliding motion of the fascia in those with low back pain is not smooth; they may have awkward movements, shifting greatly while catching or hitching *7. Previously, it was simply thought that “the movement is poor,” but fine analysis with ultrasound revealed a state where the layers within the fascia of the lower back do not slide smoothly, resulting in large, irregular shifts.

Second, ultrasound signal analysis suggested that the internal microstructure of the fascia in individuals with low back pain is also different *7. We believe this might reflect a state where cells related to inflammation are densely packed within the fascia.

Third, in a trial involving 60 patients, after receiving manual treatments based on the clinical research protocol, this awkward movement of the fascia changed to values closer to those of healthy individuals *7.

It is important to note that this research is solely investigating the mechanical mechanisms and microstructure of the fascia; it does not yet objectively prove a direct treatment effect such as pain improvement. However, I believe it is an important first step toward “visualizing” low back pain with unknown causes.

With the technology of an ultrasound engineer and the experience of a hands-on therapist, taking advantage of these two perspectives, I will continue my research and practice to help those suffering from low back pain of unknown causes.

*7 Tomita N (2026) Investigating mechanical and acoustic properties of the thoracolumbar fascia in non-specific low back pain. Doctoral thesis, Université de Montréal. https://doi.org/10.71781/34226

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