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

Background: 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.

Aim: 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.

Design: Single-blind, randomized clinical trial.

Setting: Outpatient clinic.

Population: 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.

Methods: 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.

Results: Multiple pairwise comparisons within each group revealed statistically significant differences in all outcome variables with favor to the SCS group.

Conclusions: 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.

Clinical Rehabilitation Impact: 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.