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Strain Counter Strain With and Without Sustained Natural Aphophyseal Glide in Non Specific Neck Pain
Sponsor: Riphah International University
Summary
Non-specific neck pain is a common problem that doesn't have a specific cause like an injury or disease. It usually includes neck pain, reduced movement, poor posture like forward head position, and some level of disability that can make daily activities difficult. Physiotherapists often use hands-on techniques like Strain Counterstrain (SCS) and SNAGs (Sustained Natural Apophyseal Glides) to help reduce pain, improve movement, and correct posture. This study aims to find out if adding SNAGs (Sustained Natural Apophyseal Glides) to the usual Strain Counterstrain (SCS) treatment helps more than SCS alone in patients with neck pain. We will measure changes in pain levels, neck movement, posture (craniovertebral angle), and daily life impact (NDI) over a four-week treatment program.
Official title: Effects of Strain Counter Strain With and Without Sustained Natural Aphophyseal Glide on Pain Range Of Motion ,Craniovertebral Angle and Disability in Patients With Non Specific Neck Pain
Key Details
Gender
All
Age Range
18 Years - 60 Years
Study Type
INTERVENTIONAL
Enrollment
68
Start Date
2026-06-20
Completion Date
2026-09-20
Last Updated
2026-07-24
Healthy Volunteers
No
Conditions
Interventions
Strain Counterstrain + SNAG with Common Treatment
Group A (Experimental Group) will receive both Strain Counterstrain (SCS) and SNAGs (30). They will attend 12 sessions in total, three times per week for four weeks. First, the SCS technique will be applied to the upper trapezius, levator scapulae, and scalene muscles. The patient will lie on their back or side while the therapist finds tender points and positions the neck to reduce tension, holding that position for 90 seconds before gently returning it to neutral and checking for pain. After this, SNAGs (Sustained Natural Apophyseal Glides) will be applied, targeting spinal segments like C2-C3 for rotation and C5-C6 for flexion or extension. While the patient sits upright, the therapist will apply a sustained glide on the vertebra as the patient moves the neck in the limited direction. Each movement will be repeated 6-10 times and followed by a reassessment
Strain Counterstain (SCS) only
Group B (Control Group) will receive only the Strain Counterstrain (SCS) technique without SNAGs (31). The same neck muscles will be targeted, and the patient will lie in a similar position while the therapist identifies tender points and performs the SCS technique. No joint glides or mobilization will be applied in this group. Both groups will receive a total of 12 sessions over four weeks, with each session lasting about 40 minutes. Pre- and post-treatment assessments will be carried out to measure changes in pain (using NPRS/VAS), cervical ROM, craniovertebral angle (CVA), and neck-related disability (using the Neck Disability Index - NDI).
Locations (1)
Ibne sina hospital and research institute.
Multan, Punjab Province, Pakistan