Inclusion Criteria:
* Adult males or females (age ≥ 18 years)
* Report chronic low back pain (≥3 months) (measured by patient history and clinical evaluation)
* Pain intensity reported at baseline must be ≥4 on the pain VAS scale
* Presence of myofascial pain features in the lumbar region (e.g., localized tenderness and/or trigger points identified by a qualified clinician/therapist)
* Able to lie in supine and prone positions for study procedures
* Be able to participate fully in all aspects of the study
* Have understood and signed study informed consent
Exclusion Criteria:
* Pregnancy or breastfeeding
* Patients with the inability to stay in a prone and supine position for the required procedure durations (e.g., ≥30 minutes at a time)
* Any contraindication to an MRI exam, or severe claustrophobia that would prevent safe completion of the scan
* Previous lumbar spine surgery or history of severe lumbar injury (e.g., fracture) that, in the investigation team's judgment, would interfere with participation or safety
* Patients with known bleeding disorders or current therapeutic anticoagulation that would increase risk of bruising/bleeding with massage
* Patients with skin conditions affecting the treatment area (e.g., rash, open wound, active dermatitis) or known allergy to any materials used during treatment (e.g., gels/cleaners), if applicable
* Receipt of a new pain treatment within 3 days of the study visit (e.g., injection, ablation, spinal manipulation, massage/manual therapy) that could confound pre/post measures
* Use of short-acting opioid analgesics or sedating medications within 24 hours of the study visit
* Have an implanted device in or near the treatment area that could interfere with safe application of external pressure
* Have used an investigational drug within 30 days of study enrollment
* History of any major cardiovascular events including heart valve disease, ongoing angina, cardiac arrhythmias, congestive heart failure, acute coronary syndrome, stroke, transient ischemic attack, or peripheral vascular disease.
* Clinically significant unstable neurologic or systemic illness that would preclude safe participation, as judged by the investigation team.
* Surgical intervention for pain within 1 month prior to enrollment
* Active infection, wound, or other external trauma to the areas to be treated
* Have a known history of any condition or factor judged by the investigator to preclude participation in the study or which might hinder adherence
* Inability to provide consent
