Effects of Strain/Counter Strain on Cervical Pain & Disability: A Case Report

Abstract

Background: The use of strain-counterstrain (S-CS) as a primary intervention has been controversial due to a lack of empirical evidence. The issue is further complicated when one adds in a generalized pathological condition, such as cervical pain. Research has demonstrated that S-CS decreases pain [1-5], improves strength [4], increases mobility [2-5], improves function [1,3], and decreases disability [3]; however, none of the studies have described the application of S-CS for musculoskeletal-related cervical pain. The purpose of this case report is to describe the effectiveness of S-CS on outcomes for a patient with cervical spine pain, weakness and disability. Methods: The patient was a 36-year-old male Marine referred for a cervical sprain with neck stiffness, weakness, and pain after injury due to an explosion. Treatment consisted of S-CS for the upper trapezius and superior oblique tender points, performed twice weekly for four weeks. RESULTS: He exhibited increased cervical flexion strength measured by hand-held dynamometry; a statistically significant reduction in pain scores measured by the Numeric Pain Rating Scale (NPRS) (Figure 1), and improved disability scores measured by the Neck Disability Index (NDI) (Figure 2). Conclusion: Although a causative effect may not be inferred by this case report, results suggest a potential benefit from the use of this gentle positional release intervention for reducing pain, improving strength and function. Future studies are recommended to investigate the effectiveness of S-CS in the treatment of neck pain and disability. Disclosures: The authors acknowledge they have no commercial interest conflicts associated with this manuscript.