The STB Method: A Science-Based Clinical Approach to Treating Chronic Low Back Pain

Combining Biomechanical Diagnosis, Targeted Fascial Treatment, and Active Rehabilitation – Supported by Current Clinical Research

Chronic Low Back Pain (CLBP) is considered one of the most prevalent health issues worldwide. According to World Health Organization data, approximately 70% of the population will experience at least one episode of back pain during their lifetime, and for about 20%, this pain will develop into a chronic, persistent problem. Beyond the personal suffering and reduced quality of life, it represents a massive economic burden on healthcare systems and the economy as a whole.

One of the primary reasons low back pain becomes chronic is the lack of treatment targeting the root cause. In many cases, practitioners focus solely on the painful area—while the true source may lie in distant joints, myofascial trigger points, or compensatory movement patterns. This is where the STB (Structural Tissue Balance) method comes in, offering a systemic, precise, and research-based approach to diagnosis and treatment.

What is the STB Method?

STB was developed out of the necessity to integrate in-depth biomechanical diagnosis with manual therapy and personalized rehabilitation. The core concept is simple yet powerful: pain is often merely the result, while the source of the dysfunction lies in an entirely different structure or movement pattern. Instead of focusing solely on symptoms, STB locates the root cause—and provides direct treatment at the source.

The method consists of three primary components:

• Biomechanical Diagnosis: A comprehensive assessment of range of motion, posture, motor control, and muscular function.
• Compensation Mapping: Identifying compensation patterns and understanding their impact on distal areas of the body.
• Tailored Treatment: Selecting the most precise technique—HVLA manipulations, mobilizations, targeted fascial therapy, or active exercise.

STB vs. Other Approaches

Many treatments focus on the pain itself—whether through medication, heat/cold, general massage, or non-specific exercise. While these may provide temporary relief, they do not address the source of the problem, leading to high recurrence rates. STB is different because it bridges several worlds:

• Integration of Modalities: It combines precise manual therapy with tailored rehabilitative exercise.
• Holistic Systemic View: It treats the entire body as a single system rather than a collection of isolated regions.
• Evidence-Based: It is based on current research demonstrating the superior benefits of combining manual therapy with active rehabilitation.

Clinical Research on Fascial Therapy and Exercise

In 2020, a clinical study examined the impact of adding Myofascial Trigger-Point Compression Therapy to an established exercise program for patients with Chronic Low Back Pain (CLBP). The study involved dozens of patients divided into two groups: one received an exercise program only, while the other received the same program supplemented with targeted fascial therapy.

The study results were conclusive:

• Pain Reduction: The integrated group reported an average decrease of approximately 5.6 points on the Visual Analog Scale (VAS), compared to only 3.6 points in the exercise-only group.
• Functional Improvement: In the Oswestry Disability Index (ODI), an improvement of 36 points was observed, compared to only 22 points in the control group.
• Quality of Life: The SF-12 index showed an increase of 41 points compared to 29 points.

 

The implication is clear: when targeted fascial treatment is combined with exercise, the clinical outcomes are significantly superior to exercise alone. This is exactly the evidence-based approach implemented in the STB method.

What Does This Mean for Therapists?

The aforementioned study validates what many manual therapists observe in the clinic daily: a treatment based on targeted touch, fascial release, and integrated rehabilitation is more effective than rehabilitation alone. For a therapist working according to STB principles, this research provides scientific reinforcement for an approach that is already proving its clinical worth.

Furthermore, the results highlight the critical importance of:

• Precise Diagnosis Prior to Treatment: Ensuring the intervention is targeted at the actual source rather than just the symptom.
• Early Identification of Compensations: Preventing the development of new compensatory patterns that could lead to secondary issues.
• Integrating Diverse Techniques: Combining HVLA, mobilizations, targeted fascial therapy, and active exercise within a single, cohesive treatment plan.

Clinical Case Studies

Case 1: Postpartum Chronic Low Back Pain A 38-year-old female patient presented with chronic low back pain following two births. An STB assessment identified active trigger points in the Latissimus Dorsi and Erector Spinae muscles, alongside core muscle weakness. The integration of targeted fascial therapy with a tailored exercise program led to a significant reduction in pain within four weeks.

Shutterstock

 

Case 2: Professional Athlete with Recurrent Back Pain A professional athlete struggling with recurrent back pain following heavy resistance training. The assessment revealed hip joint overloading and compensatory patterns in thoracic spine mobility. STB treatment addressed the thoracic-hip dissociation, allowing him to return to full training while maintaining enhanced performance.

 

Case 3: Physical Laborer with Distal Compensation A 55-year-old male with long-standing low back pain and a demanding physical job. The STB examination identified a range-of-motion restriction in the left ankle, which led to a compensatory pattern in the right knee and subsequent lumbar strain. Treating the ankle restriction and releasing lumbar trigger points resulted in marked improvement and a decreased reliance on pain medication.

Summary

The STB method represents a science-based clinical approach that successfully bridges the gap between precise diagnosis, targeted manual therapy, and active rehabilitation. The clinical research described clearly indicates that integrating fascial therapy with exercise is significantly superior to exercise alone, reinforcing the core principles upon which the method is built.

For therapists, this is a powerful tool that enables not only pain reduction but also the modification of movement patterns, the prevention of new compensations, and a long-term improvement in patients' quality of life.

Article Author: Giveon Peled Founder of the STB Method and specialist in pain management.

Want to learn how to apply the STB method in a professional, research-based manner?

Clinical Research

Masarwa R, Uri O, Peled G, Laufer G, et al. Myofascial trigger-point compression therapy as an adjunct to exercise program for chronic low back pain. 2020.