Influence of adding strain-counterstrain to standard therapy on axioscapular muscles amplitude and fatigue in mechanical neck pain: a single-blind, randomized trial.
Yasmin S El-Khateeb, Amira G Mahmoud, Mai H Mohamed and 1 others
PMID 35666489WHAT IT FOUND
Adding strain-counterstrain to standard exercise therapy reduced pain and disability more effectively than exercise alone in patients with mechanical neck pain.
Both groups improved, but the group receiving manual release techniques showed greater gains in pain scores and function.
Key findings
01Patients receiving strain-counterstrain plus standard therapy had significantly lower pain scores and disability than those receiving standard therapy alone after four weeks.
02The increase in pressure pain threshold in the strain-counterstrain group was statistically significant but did not reach the threshold for clinical significance.
03Standard therapy alone also produced significant improvements in pain, disability, and muscle activity measures within the control group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study assessed outcomes only after four weeks, so long-term effects are unknown. The improvement in pressure pain threshold, while statistically significant, was not clinically meaningful according to the authors' own criteria. The sample size was relatively small, and the study was single-blind, meaning participants knew which treatment they received. The control group received a comprehensive standard therapy package, so the added benefit of SCS was measured against a strong active comparator, not a placebo or no treatment.
Declared interests
No specific funding sources or author conflicts of interest were reported in the provided text.
The easy way to misread this
Do not assume the manual technique provides a clinically meaningful change in pain sensitivity. The authors explicitly state that the improvement in pressure pain threshold did not reach the level considered clinically significant, despite the statistical difference.