Effect of Strain Counter-strain Technique versus Conventional Physiotherapy on Acute Non-specific Neck Pain and Disability among College Amateurs: A Randomised Controlled Trial

Introduction: Non-specific neck pain frequently presents in conjunction with Myofascial trigger points (MTrPs) in the upper trapezius muscle. The Strain Counter-Strain (SCS) technique is a widely recognised method for the treatment of MTrPs. Additionally, modalities such as hot packs, therapeutic ultrasound, and Transcutaneous Electrical Nerve Stimulation (TENS) have demonstrated efficacy in the management of Upper Trapezius Myofascial Pain Syndrome (UTMPS). However, there is a paucity of literature directly comparing the SCS technique with conventional physiotherapy within the same clinical trial, particularly for the treatment of acute neck pain in athletic populations. Aim: The present study aimed to compare the effectiveness of the strain counter-strain technique and conventional physiotherapy in reducing upper trapezius muscle tenderness among college amateur athletes. Materials and Methods: A single-blinded randomised controlled trial was conducted in the Department of Physiotherapy at NIMS University, Jaipur, India, from September 2024 to March 2025. A total of 66 patients with trigger points in the upper trapezius muscle were recruited and randomly allocated into two groups. Group I (n=33; males=17, females=16) received the strain counter-strain technique applied to the upper trapezius muscle, while Group II (n=33; males=15, females=18) received conventional physiotherapy. All participants were evaluated at baseline using the Numeric Pain Rating Scale (NPRS) and the Neck Disability Index (NDI). Statistical analysis was performed using paired and unpaired t-tests, with a p-value of <0.05 considered statistically significant. Results: The SCS technique was significantly more effective than conventional physiotherapy in reducing pain and disability. Statistically significant improvements were observed in NPRS scores (p-value <0.0035) and NDI scores (p-value <0.0486). Conclusion: The SCS technique demonstrated significantly greater efficacy in alleviating pain and reducing disability compared with conventional physiotherapy in individuals with acute non-specific neck pain, particularly those experiencing tenderness in the upper trapezius region. This innovative approach appears to be a valuable therapeutic option for the management of neck pain, offering improved pain relief and functional outcomes.