title: Strain-counterstrain to treat restrictions of the mobility of the cervical spine in patients with neck pain: a sham-controlled randomized trial.
abstract: OBJECTIVE
  Strain-counterstrain is an osteopathic technique which is widely used for treating mobility restrictions in the neck. We aimed to investigate whether a single strain-counterstrain intervention is more effective than a sham intervention in improving restricted cervical range of motion in patients with neck pain.
  
  
  METHODS
  61 adult patients with neck pain and restricted cervical mobility were randomly allocated to receive either a single strain-counterstrain intervention or a sham treatment. After outcome measurement all patients received full individualized osteopathic treatment. Mobility of the cervical spine was measured by a blinded observer using the Cervical Range of Motion (CROM) tool. In addition, patients rated pain intensity and assessed the treatment effect. The main outcome measure was the sum of changes in mobility restriction (in %) after treatment compared to normal mobility.
  
  
  RESULTS
  All patients completed the study. Mobility restriction decreased by 2.0% (SD 6.9%) in the group receiving strain-counterstrain treatment and 0.6% (SD 5.7%) in the group receiving sham treatment (mean difference 1.5%, 95% confidence interval -1.7 to 4.8%; p=0.35). There were no significant differences between groups for secondary outcomes. After receiving the full osteopathic treatment the group initially receiving strain-counterstrain improved by another 4.2% (7.0%; p=0.003) and the group initially receiving sham by another 5.6% (SD 6.8%; p<0.001).
  
  
  CONCLUSIONS
  Strain-counterstrain as a single intervention did not have immediate effects on mobility and pain over a sham treatment. Future studies should probably focus on the investigation of full osteopathic treatment.
authors: Institute of General Practice, Techni-sche Universität München, Munich, Germany.
authors: Reinhold
authors: R
authors: Klein
authors: Alexa
authors: A
authors: Bareis
authors: Antonius
authors: A
authors: Schneider
authors: Klaus
authors: K
authors: Linde
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D026301:Manipulation, Osteopathic / Q000379:methods*; D008875:Middle Aged; D051346:Mobility Limitation; D019547:Neck Pain / Q000628:therapy*; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric; D016896:Treatment Outcome