A randomised controlled trial of Strain-Counterstrain

INTERVENTION: Strain‐Counterstrain treatment treatment will involve passive positioning of the participant, with varying degrees of cervical flexion/extension, lateral flexion and rotation, such that there is a two‐thirds reduction in tenderness at a monitored digitally tender point (Jones et al 1995). This is to be determined by having participants rate their tenderness to palpation at digitally tender points on a numerical pain scale where 10 represented initial tenderness and 0 no tenderness. In addition to reported tenderness with intermittent digital probing, perceived tissue tension will be used to guide the experimenter to the appropriate passive position (Jones et al 1995). The participant will be passively maintained at this point by the experimenter for approximately 90 seconds, with intermittent digital probing at 30‐sec intervals to ensure correct positioning, before being slowly and passively returned to a neutral position (Jones et al 1995, Kusunose and Wendorff 1990, Kusunose 1993). Treatment using a digitally tender point will be considered successful if tenderness is reduced by 70% or more (3/10 or less with digital probing) (Kusunose 1993, Kusunose and Wendorff 1990), however the intention will be to reduce tenderness to a numerical pain rating of 1/10 or less with digital probing. This treatment is to be provided in two half hour sessions in a one week period. CONDITION: Non‐specific acute neck pain PRIMARY OUTCOME: Neck Disability Index SECONDARY OUTCOME: Fear avoidance beliefs questionnaire Global rating of change SF‐36 health questionnaire Visual analogue scale for pain rating INCLUSION CRITERIA: 1) Neck pain (Merskey and Bogduk 1994) of less than 30 days duration 2) Between 18 and 60 years 3) Initial VAS pain rating less than 7/10 4) Initial neck disability index score between 20 and 52 5) Able to lie supine for 10 minutes 6) Displaying a minimum of four digitally tender points at examined sites (Kusunose and Wendorff 1990) at their initial assessment.