Strain Counterstrain Technique Research Articles

Effect of Strain Counterstrain Technique and Core Strengthening Exercises on Pain and Functional Status among Middle Aged People with Chronic Low Back Pain

Background: Low back pain (LBP) is characterized as “pain along the posterior portion of the body from the lowerborder of the twelfth rib to the lower gluteal folds. A technique called strain counterstrain method is used to treatmusculoskeletal pain. Core strengthening exercises can also lead to significant improvements in pain reductionand functional status. The goal of this study is to find the effectiveness of strain counterstrain technique and corestrengthening exercises in treating low back pain.Methods: Total of 100 participants were chosen from Capital hospital, Vijayawada by convenient sampling,During study period from September 2022 to July 2023. A written consent form was obtained from them. Afterobtaining pre-test of VAS and Oswestry disability questionnaire the patients were categorised randomly into twogroups. GROUP A received Strain counterstrain technique alone and GROUP B received Strain counterstraintechnique with core strengthening exercises.Result: A statistically significant difference was found between GROUP A and GROUP B as well as within thegroup, according to the statistical analysis performed on the quantitative data.Conclusion: The findings of the present study demonstrate improvements in both Strain counterstrain techniqueand core strengthening exercises among middle aged people with chronic low back pain. However, (GROUP B)shows an extremely significant improvement compared to (GROUP A).

Effects of a program consisting of strain counterstrain technique, phonophoresis, heat therapy, and stretching in patients with temporomandibular joint dysfunction: Erratum.

Effects of a program consisting of strain counterstrain technique, phonophoresis, heat therapy, and stretching in patients with temporomandibular joint dysfunction: Erratum.

A Study of 45 Patients with Chronic Neck Pain to Compare the Effects on Pain and Disability of 4 Weeks of Physical Therapy with the Active Release Technique and Strain-Counterstrain Manipulation with Massage Alone, Before and After Treatment.

BACKGROUND Active release technique (ART) and strain-counterstrain (SCS) have been reported to be beneficial for patients with trigger point pain. Therefore, this study of 45 patients with chronic neck pain aimed to compare the effects of 4 weeks of physical therapy with the ART and SCS manipulation with massage alone, evaluated before and after treatment, using the visual analog scale (VAS) for pain, the neck disability index (NDI), and the pressure pain threshold (PPT). MATERIAL AND METHODS The participants were 45 adults with neck pain lasting >12 weeks, divided into the ART group (n=15), SCS group (n=15), and control group (n=15). All groups received clinical massage (CM) for 15 min twice a week for 4 weeks. The control group received only CM, the ART group received CM and ART for 15 min twice a week for 4 weeks, and the SCS group received CM and SCS for 15 min twice a week for 4 weeks. VAS, NDI, and PPT were measured before and after the interventions. RESULTS In all groups, there were significant changes in VAS, NDI, and PPT after the interventions (P<0.05), and there was a significant difference among groups in the difference before and after intervention (P<0.05). VAS and NDI showed the greatest difference among before and after intervention in the ART group (VAS pre-post 3.38±0.76, NDI pre-post 5.69±2.78). PPT showed the greatest difference among before and after intervention in the SCS group (PPT pre-post 1.75±0.62). CONCLUSIONS The ART technique and the SCS technique effectively reduced neck pain and neck disorders in adults with chronic neck pain.

Effects of a program consisting of strain/counterstrain technique, phonophoresis, heat therapy, and stretching in patients with temporomandibular joint dysfunction: A pilot study.

The present study was conceptualized as a pilot study to examine the effects of a 3-week program consisting of strain/counterstrain technique (SCST), phonophoresis, heat therapy, and stretching exercises on pain and functions in patients with temporomandibular dysfunction (TMD). Seven participants (mean age 25.85 years) diagnosed with TMD having pain in the temporomandibular joint (TMJ) area with decreased jaw opening were recruited for the study. Treatment interventions consisting of SCST, phonophoresis (ultrasound gel mixed with diclofenac gel), heat therapy, and stretching (mouth-opening) exercises were performed 3 days a week for 3 weeks. SCST was performed on the masseter, medial, and lateral pterygoid muscles. No control group was present in the study. Paired samples t test revealed a significant difference in numerical pain rating scale (NPRS) (decreased by 50%, P < .001) and jaw functional limitation scale (JFLS) (reduced by 59.58%, P < .001) scores after 3 weeks of intervention. A large effect size (Cohen d = -3.00 for NPRS and -3.16 for JFLS) was observed for both variables. No correlation (R = 0) was found between the baseline values of NPRS and JFLS. A 3-week program consisting of SCST, phonophoresis, heat therapy, and stretching exercises was effective in reducing the pain and improving the functions related to TMJ in patients suffering from TMD. However, a randomized controlled trial is needed to reach a definite conclusion.

The Role of Manual Therapies in the Treatment of Headache Disorders.

A comprehensive headache treatment plan typically requires both medication and non-medication treatment strategies. Manual therapies offer another therapeutic approach to headache treatment. This article reviews the evidence for manual therapies in the treatment of headache disorders. Current evidence shows potential benefit from myofascial trigger point injections, myofascial release, and massage for the treatment of various headache types. There is also evidence for strain counterstrain technique, ischemic compression, and spinal manipulative therapies for cervicogenic headache. Although larger randomized clinical trials are necessary for many of these modalities, recent findings show that manual therapies could be an important tool for the treatment of some headache disorders.

The Masticatory Structure and Function in Children with Cerebral Palsy—A Pilot Study

(1) Background: Muscle tension around the head and neck influences orofacial functions. The data exist concerning head posture during increased salivation; however, little is known about muscle tightness during this process. This study aims to investigate whether or not any muscles are related to problems with eating, such as drooling in individuals with cerebral palsy; (2) Methods: Nineteen patients between the ages of 1 and 14 were examined prior to the physiotherapy intervention. This intervention lasted three months and consisted of: relaxing muscles via the strain-counterstrain technique, functional exercises based on the NeuroDevelopmental Treatment-Bobath method, and functional exercises for eating; (3) Results: the tone of rectus capitis posterior minor muscle on the left side (p = 0.027) and temporalis muscle on the right side (p = 0.048) before the therapy, and scalene muscle on the right side after the therapy (p = 0.024) were correlated with drooling behavior and were considered statistically significant. Gross motor function was not considered statistically significant with the occurrence of drooling behavior (p ≤ 0.05). Following the therapeutic intervention, the frequency of drooling during feeding decreased from 63.16% to 38.89% of the total sample of examined patients; (4) Conclusions: The tightness of the muscles in the head area can cause drooling during feeding.

Comparative Effects of Strain Counterstrain and Ischemic Compression Technique in Patients with Upper Trapezius Trigger Points

Background: The trigger points are hyperirritable spots found usually in the muscle fascia or within the taut bands of skeletal muscles that is painful on compression. Ischemic compression technique uses the application of sustained pressure with sufficient force and for long enough so as to slow down the flow of blood and releasing tension out of the muscle. Strain counterstrain (SCS), also known as positional release, is a passive positional treatment that relieves musculoskeletal pain and dysfunction by indirect hand manipulation. Objectives: The aim of this study was to compare the effects of ischemic compression technique and strain counterstrain technique on pain, neck lateral flexion and disability in patients with upper trapezius trigger points. Methodology: The RCT was conducted on 36 male and female participants aging 25-45 having maximum of 5 trigger points in the upper trapezius bilaterally. The patients were divided equally to ischemic compression and strain counterstrain group by lottery method. The treatment was given for 3 days a week for 4 weeks. The NPRS, NDI and cervical lateral flexion were used as outcome measure. The assessment of the outcome measures was done on baseline, after 2nd week and after 4th week. The data was analyzed by SPSS version 26 using appropriate tests depending upon the normality by keeping the level of significance at 0.05. Results: Out of 36 participants (Mean age 32.96 ± 5.91), 20 were male and 16 were female, 3 participants lost to follow up. The within group analysis of NPRS and NDI done by Friedman test and that of cervical flexion done by repeated measures ANOVA showed that the both the interventions has produced significant (p&lt;0.05) effects on pain, neck disability and range of motion, but the between group analysis of NPRS and NDI done by Mann-Whitney test and that of Cervical ROM done by Independent samples t-test showed that none of the two technique produced significant results (p&gt;0.05) as compared to the other in subjects with upper trapezius trigger points. Conclusion: A 4-week intervention of the ischemic compression and strain counterstrain produced significant results in reducing the intensity of pain, the cervical disability and improving the cervical range of motion, but the intergroup comparison showed that both the ischemic compression and strain counterstrain were equally effective and none of them produced significant results as compared to others on patients with upper trapezius trigger points. Keywords: Ischemic Compression Technique; Strain Counterstrain; Upper Trapezius Trigger Points.

Comparison of Effectiveness of Muscle energy Technique with Strain Counter Strain Technique on the Patients of Non-Specific Neck Pain

Non-specific neck pain is a condition which is diagnosed through symptoms when serious and objective cervical spinal pathology (e.g., trauma, malignancy, radiculopathy, etc.) has been ruled out. Many studies have done previously for both techniques, muscle energy technique and strain-counter strain technique, for treatment of patients with non-specific neck pain Objective: To compare the effectiveness of Muscle Energy Technique with Strain Counter- Strain Technique in patients with non-specific neck pain Methods: Single blinded randomized clinical trial was conducted. The assessor was blinded from the allocation in the groups. Forty Patients were included in the study divided into two groups; each group received one technique. They were followed for Seven sessions. Questionnaire including visual analogue scale, NDI were used to collect pre-treatment and post- treatment data. Data was analyzed by using SPSS ver. 21. Independent sample t test was applied to compare means of patients Results: Neck flexion of the Patients pretreatment Mean Group 1:24.6500, Group2:23.0500. Neck Flexion of the patient after treatment Mean Group 1(SCS) 32.0500 Group 2(MET) 40.0000 Neck Extension of the Patient pretreatment Mean Group 1: 33.8500 Group 2: 30.6500. Neck extension of the patients. Post treatment Mean SCS 41.5000 MET53. 2500.The given results and detailed results given in the table shows that both techniques are improving ROM, but MET are more effective than SCS. p value is 0.001 which is significant Conclusion: This study concluded that Muscle Energy Technique is better in reducing pain as compared to Strain Counter Strain Technique

Influence of adding strain-counterstrain to standard therapy on axioscapular muscles amplitude and fatigue in mechanical neck pain: a single-blind, randomized trial.

Strain-counterstrain technique (SCS) or positional release therapy is strongly recommended for patients with mechanical neck pain (MNP) because this method has excellent benefits, but the clinical significance of this method is unclear. The aim of this study was to investigate the influence of adding the SCS technique to standard therapy on pain, pressure pain threshold, disability according to Neck Disability Index (NDI), and electrophysiological characteristics (amplitude and fatigue) of the upper part of trapezius in the axioscapular muscles of patients with mechanical neck pain. Single-blind, randomized clinical trial. Outpatient clinic. Sixty patients (19-38 years old) with mechanical neck pain participated in this study and were recruited from the outpatient clinic at the faculty of physical therapy after a referral from an orthopedist. Patients were randomly assigned by opaque sealed envelope to two treatment groups: group A received SCS, standard therapy in form of active range of motion, stretching exercises, and postural correction exercises (PCES), whereas group B, received standard therapy only; therapeutic sessions were performed three times/week for 4 weeks. The visual analogue scale, pressure pain threshold, NDI, upper trapezius median frequency, and root mean square were used to evaluate the patients' pretreatment and post-treatment status. Multiple pairwise comparisons within each group revealed statistically significant differences in all outcome variables with favor to the SCS group. The Strain-counterstrain technique combined with traditional standard therapy is an effective method more than traditional standard therapy alone for the management of patients with MNP. The present study has implications, especially for clinical decision-making about therapy of choice in MNP to reduce pain, improve function as measured through SCS technique and its impact on normal lifestyle, and to highlight the need for active intervention.

English

BACKGROUND Evidence till date indicates high incidence of neck pain, and soft tissue techniques [muscle energy technique (MET), strain counter strain (SCS)] have proven to be effective for non-specific neck pain (NSNP). However, their comparative effect is yet to be proven, hence the present study attempted to investigate the comparative effectiveness of MET with SCS techniques in individuals with NSNP. METHODS Total 10 participants diagnosed with NSNP were included in the study. They were allocated into two groups utilizing convenient sampling. Group A received MET with SCS technique and Group B received MET with conventional physiotherapy. The interventions were given for 2 weeks, 3 sessions per week for 45 minutes. The outcome measures used in the study were numeric pain rating scale (NPRS), neck disability index (NDI), range of motion (ROM) which were assessed before the intervention immediately after the first session and at 1st week and end of 2nd week. RESULTS Intragroup comparison found to be significantly reduced in terms of pain and neck disability index and improvement in cervical range of motion (P = &lt; 0.05). However intergroup comparisons showed significant difference in Group A only at the end of 2nd week of intervention (P = &lt; 0.05), but the results were not significant immediately and at the 1st week of intervention (P = &gt; 0.05). CONCLUSIONS The study concluded that MET with SCS technique is more effective in reducing pain, neck disability and improving cervical range of motion. KEY WORDS MET, SCS, NSNP

Immediate Effect of Strain Counterstrain Technique versus Muscle Energy Technique on Upper Trapezius Tenderness in Non-Specific Neck Pain

Background: The most common form of neck pain is non-specific which is deep, dull aching &amp; poorly localized. Non-specific pain is associated with upper trapezius tenderness. For people who work at desks and computers, or who spend many hours driving, have poor ergonomics which causes the upper trapezius to become sore and painful. The soreness can lead to the development of tender points which can be the major reason for developing neck pain and muscle spasm. Physiotherapy techniques like muscle energy technique and Strain counterstrain has been proposed to treat tenderness in trapezius. Objective: To compare the immediate effect of Strain Counterstrain Technique &amp; Muscle Energy Technique on pain, pain pressure sensitivity &amp; mobility on non-specific neck pain with upper trapezius tenderness using Visual analogue scale, Pressure Algometer &amp; Universal Goniometer respectively. Method: 60 subjects were selected as per inclusion and exclusion criteria&amp; were randomly assigned to Group A (n=30) &amp; Group B (n=30); Strain Counterstrain and Muscle Energy Technique respectively. Visual Analogue Scale, Pain Pressure Sensitivity &amp; Cervical Rotation &amp; Lateral Flexion Motion bilaterally was noted before &amp; after application of both techniques and the data was statistically analysed. Result: Both groups showed statistical significance (p&lt; 0.05) differences in all outcome measures between pre test and post test values of Group A and Group B but there is no statistical significant (p&gt; 0.05) difference in the outcome measures between groups. Conclusion: The study concludes that both techniques are equally effective in treating pain, increasing lateral flexion and rotation range of motion, and improving pain pressure sensitivity. Keywords: Strain Counterstrain, muscle energy technique, upper trapezius tenderness,visual analog scale, non-specific neck pain,pain pressures sensitivity.

Effects of myofascial release applied to neck muscles and craniocervical flexor training in patients with chronic myofascial TMD: A single arm study

ObjectiveTo evaluate the effects of myofascial trigger point release applied to superficial neck muscles and strengthening of the deep flexor muscles in subjects with myofascial temporomandibular disorders (mTMD). MethodsFourteen women (23.4 ± 3.32 years old) presenting with mTMD and trigger points (TrPs) in the sternocleidomastoid, suboccipital, and upper trapezius muscles were included in this study. They were evaluated on two occasions during a baseline period (3 weeks apart) with no intervention and a third time after a 5-weeks intervention protocol. Outcome measures included pressure pain threshold (PPT) over the masticatory muscles, mandibular function, orofacial pain intensity, maximum mouth opening, and the craniocervical flexion test. All women received 10 treatment sessions that included strain-counterstrain technique applied to TrPs found in the prior listed superficial neck muscles and stabilization exercise using a pressure biofeedback for the deep neck flexor muscles. One-way ANOVA or correspondent non-parametric tests as well as effects sizes were used to compare the outcomes at baseline and after the treatment. ResultsStatistically significant improvements were found in the PPT over left masseter and temporalis (p < 0.05) (mean difference (MD) of 0.50 and 0.42 kg/cm2), orofacial pain intensity (MD = −3.39 points), mandibular function (MD = −7.22 points) and performance of the deep cervical muscles (MD = 130.42 points) compared to baseline period. Effect sizes were moderate or large. ConclusionThe protocol intervention may have positive effects in patients with mTMD. However, studies with better methodological quality need to be performed to confirm those effects. Registrationensaiosclinicos.gov.br (RBR-7x828q);

【論文摘要】The Immediate and Lasting Effects of Strain Counterstrain Technique on Trigger Points or Tender Points: A Systematic Review and Meta-analysis

Background and Purpose: Strain counterstrain (SCS), also known as positional release, is an indirect osteopathic manipulative technique to relieve musculoskeletal pain and dysfunction such as myofascial trigger points. SCS begins by identifying specific tender points related to musculoskeletal pain and dysfunction, and then the practitioner positions the patient in the position-of-comfort which is typically obtained by shortening tissues around tender points for 90 seconds. The purpose of this study was to investigate the immediate and lasting effects of SCS technique on trigger points or tender points. Methods: Three databases (Pubmed, ScienceDirect, and Google Scholar) were searched and articles were included if met the following criteria: (1) subjects were randomly assigned to one of treatment groups; (2) subjects with identified trigger points or tender points; (3) the intervention group received either SCS technique alone or SCS technique combined with other treatment which was the same as control group; (4) the control group received no treatment, sham treatment, or other treatment which not contained SCS technique; (5) outcome measures contained visual analog scale (VAS) of pain intensity or pressure pain threshold (PPT) of trigger points or tender points. Results: A total of ten studies were included and analyzed. Immediately after single or multiple sessions of treatment, there was significant improvement of both VAS (standardized mean difference [SMD] = -1.85, p ＜ 0.0001) and PPT (SMD = 1.08, p ＜ 0.0001) in the intervention group compared with the control group. Moreover, 1-4 weeks after the end of multiple sessions of treatment, there was significant improvement of VAS (SMD = -0.56, p = 0.02) but no significant improvement of PPT (SMD = 0.97, p = 0.08) in the intervention group compared with the control group. Conclusion: This meta-analysis indicated that there were both immediate and lasting effects of SCS technique on significantly decreasing VAS and there was immediate effect of SCS technique on significantly increasing PPT. Clinical Relevance: This meta-analysis suggests that SCS technique can decrease pain intensity and sensitivity of trigger points or tender points.

Impact of strain-counterstrain on treatment of acute nonspecific low back pain: a single-blind randomized controlled trial

PurposeThe study was to assess the effectiveness of strain-counterstrain (SCS) techniques, after treatment and after a 6-week follow-up, on pain, range of motion (ROM), and disability in patients with acute nonspecific low back pain with mobility deficits.MethodsSCS techniques (group A) and 42 (group B, control group) were advised to be active. The pressure pain threshold (PPT), lumbar flexion ROM, and Oswestry Disability Index (ODI) were used for assessment. All patients were assessed before treatment, after treatment, and after a 6-week follow-up. The treatment program was applied for 2 weeks, 2 sessions per week.ResultsStatistical analysis revealed that there were significant increases in PPT on both sides of L5 and lumbar flexion ROM. In addition, a significant reduction in ODI scores was observed (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) in the pre- vs. post-treatment evaluation, in the pre-treatment vs. post-6-week evaluation, and in the post-treatment vs. post-6-week evaluation with regard to both groups. As for between-group effects, multiple pairwise comparisons revealed significant increases in PPT on both sides of L5 and lumbar flexion ROM, in addition to a significant reduction in ODI scores (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) in favour of group A as compared with group B after treatment and after the 6-week follow-up.ConclusionsSCS is preferable to be advised in the treatment of acute nonspecific low back pain with mobility deficits.

The Effects of Dry Needling Compared to Manual Therapy Techniques in Patients with Myofascial Neck Pain: A Systematic Review

Neck/shoulder pain is one of the most common pain conditions with a prevalence in the general population being estimated between 10% and 15% (Sobhani, et al., 2016). It is more common in females than males. Manual trigger points are the common cause for this pain. There are many different forms of treatment to help manage these trigger points such as dry needling, friction massage, ischemic compression, manual pressure, orthopedic manual therapy, soft tissue massage, and strain-counterstrain technique. The aim of this systematic review and meta-analysis was to determine the effectiveness of pain reduction, increasing range of motion, and pressure pain threshold (PPT) using dry needling compared to manual therapy techniques in patients with neck/shoulder pain. The six articles meeting the inclusion criteria all had similar results. The outcomes being measured were pain intensity, neck disability index, pressure pain threshold, and cervical range of motion. All the articles showed dry needling compared to any of the other treatment groups were equally as effective in treating patients with myofascial pain symptoms. Overall, it has been shown dry needling compared to the other noninvasive manual therapy treatment methods had no significant differences between the outcomes; however, those outcome measures all had improved results. Future studies are needed to investigate the long-term effects and other possible involved muscles and their responses to the different treatments.

The PENATALAKSANAAN FISIOTERAPI PADA PENDERITA GANGGUAN NYERI AKIBAT SINDROM PIRIFORMIS DENGAN TEKNIK STRAIN COUNTERSTRAIN DAN CONTRACT RELAX STRETCHING DI KELURAHAN PEKAPURAN RAYA KOTA BANJARMASIN

Continuous use of muscles can may caused hyperactively muscle activity which eventually induced pain and muscle spasm in the lower back area to the backside. In addition, muscle spasm may lead pressure on the nerves to generated swelling, inflammation, and symptoms of nerve irritation. One of the nerve irritations that often results from muscle spasm is piriformis syndrome. Piriformis syndrome is a musculoskeletal condition characterized by pain in the waist, lower back to the backside upper lower limbs that results from shortening or spasm piriformis obtained compression of the sciatic nerve. As a result of these problems, the authors conducted a study to determine the management of physiotherapy using Strain Counterstrain technique and Contract Relax Stretching in reducing pain due to Piriformis syndrome. This research was conducted in the Kelurahan Pekapuran Raya of Banjarmasin City using a case study method with a visual analog scale (VAS) and Brief Pain Inventory Questionnaire (BPI). The results of the study are Strain Counterstrain and Contract Relax Stretching for 12 times therapy in 4 weeks can reduce pain disorders in the condition of Piriformis syndrome.&#x0D;

Strain counter-strain technique versus kinesio tape in treating patients with myofascial neck pain syndrome

Myofascial pain syndrome is one of the most common complaints in clinical practice. Strain counter-strain technique is non-invasive therapeutic modality for treatment of soft tissue disorders. Kinesio tape is now widely used in management of musculoskeletal injuries. Forty-five patients with myofascial neck pain syndrome assigned randomly into: strain counter-strain technique group ( n = 15), kinesio tape group ( n = 15) and control group ( n = 15). The strain counter-strain technique was applied for two weeks (3 sessions/week-20 minutes per session). Kinesio tape was applied for upper Trapezius muscle for two weeks (3 days on and one day off). Pressure algometry, Visual Analogue Scale (VAS) and Neck Disability Index (NDI) were used to evaluate participants before and after the corresponding interventions. Analysis of variance test (Anova) was used to determine differences between groups for all measured parameters. Paired t -test was used to compare between the pre- and post-treatment values within groups. For the 45 study participants (33 women and 12 men; mean age = 44.1 ± 7 years) statistical analysis revealed that subjects in strain counter-strain technique and kinesio tape groups experienced significant increase in pressure pain threshold, decrease in neck disability scale and pain level than those in the control group in favour of strain counter-strain technique group ( P > 0.05). The results suggest that treatment with strain counter-strain technique and kinesio tape were effective however strain counter-strain technique was more effective for management of myofascial neck pain syndrome.

Effect of muscle energy technique with and without strain-counterstrain technique in acute low back pain - A randomized clinical trial.

Background:Muscle energy technique (MET) and strain–counterstrain (SCS) technique are found to be effective as a sole treatment of acute low back pain (LBP), but the combined effect of these two techniques has not been evaluated.Objective:The purpose of this randomized clinical trial was to evaluate the added effect of SCS to MET in acute LBP patients.Methods:In this trial, 50 patients were randomly allocated to MET or MET-SCS group to receive the assigned two treatment sessions for two consecutive days. Oswestry disability index (ODI) and Roland Morris disability questionnaire (RMDQ), visual analogue scale (VAS), lumbar range of motion (ROM) were recorded at baseline, after first and second session.Results:All the outcome measures showed statistically significant () improvement in both the groups after second session. Between the groups, analysis showed no statistically significant difference () after the first or second session.Conclusions:The improvement after second treatment sessions was noted in pain, ROM, and disability in both the groups, but immediate effect was seen only on pain intensity after first treatment session. When compared between the groups, no added effect of SCS to MET was found in reducing pain and disability and increasing lumbar ROM in acute LBP patients.

Effectiveness of Strain Counterstrain Technique and Neural Tissue Mobilisation on Cervicogenic Headache

Effectiveness of Strain Counterstrain Technique and Neural Tissue Mobilisation on Cervicogenic Headache

Trigger point dry needling versus strain-counterstrain technique for upper trapezius myofascial trigger points: a randomised controlled trial.

Treatment of active myofascial trigger points includes both invasive and non-invasive techniques. To compare the effects of upper trapezius trigger point dry needling (DN) and strain-counterstrain (SCS) techniques versus sham SCS. Randomised controlled trial. 34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects' own ratings of perceived disability were measured. The analysis of variance mixed model showed a significant time effect for pain (p<0.001), elicited pain (p<0.001), pain pressure threshold (p<0.01), and neck disability index (p=0.016). Pain at rest decreased in all groups, as follows: DN 18.5 mm (95% CI 4.3 to 32.7 mm); SCS 28.3 mm (95% CI 12.4 to 44.1 mm); sham SCS 21.9 mm (95% CI 3.5 to 40.1 mm). Reductions in disability score (points) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI -4.9 to 2.1) or sham SCS (1.8, 95% CI -6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied. There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size. NCT01290653.