Neck PainNCT07026006
Active Release Versus Strain-Counter-strain Technique in Patients With Non-Specific Neck Pain
A study testing Active Release Technique and Strain-counterstrain in people with Neck Pain, run by Riphah International University at 1 site in Pakistan.
Trial summary
The study design will be a randomized clinical trial (RCT) aims to compare the effects of Active Release Technique and Strain-Counterstrain on pain, range of motion, cranio-vertebral angle, and disability in patients with non-specific neck pain. Data will be collected from Safi Teaching Hospital, Faisalabad, Pakistan. Read more about this study
- Who is it for?
- Ages 18 to 45 years
- Conditions the study is for
- Neck Pain
- What is being tested?
- Active Release Technique and Strain-counterstrain
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 sitePakistan
- Study dates
- 1 May 2025to 28 Sep 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age 18-45 years
- Both male and female
- Patients with neck pain for at least 2 months
- Palpable taut bands in upper trapezius, SCM
- ATrPs in upper trapezius, levator scapulae, SCM
- NPRS score is >3/10 on NPRS for neck region
Show all 10Show fewer
- Individuals with a Craniovertebral angle less than 53
- Individuals having grade 2 severity of neck pain according to KNGF Guidelines
- Localized pain/stiffness in cervical spine (C3-C7) without upper limb radiculopathy
- Diagnostic Tests: Negative Spurling's test, upper limb tension test, and shoulder abduction test
Who cannot join
- Myofascial treatment in the preceding month
- Diagnosis of fibromyalgia
- Congenital problems
- Trigger point injections
- Individuals with KNGF Clinical Practice Guideline Grade III and IV severity of neck pain
- Respiratory disease and joint disease
- Neurological deficit
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Riphah Rehabilitation Clinic
Lahore, Punjab Province, 54000
Syed Shakil ur Rehman, PhD, +92 320 7866611, shakil.urrehman@riphah.edu.pk
Junad Zahid, MS*
About this study
Official title: Effects of Active Release Versus Strain-Counter-strain Technique on Pain, Range of Motion, Cranio-vertebral Angle, and Disability in Patients With Non-Specific Neck Pain
The study design will be a randomized clinical trial (RCT) aims to compare the effects of Active Release Technique and Strain-Counterstrain on pain, range of motion, cranio-vertebral angle, and disability in patients with non-specific neck pain. Data will be collected from Safi Teaching Hospital, Faisalabad, Pakistan. Using a non-probability purposive sampling method, participants aged 18-45 years with localized cervical pain and stiffness will be selected based on inclusion and exclusion criteria. The inclusion and exclusion criteria will be; Participants aged 18-45, both male and female, experiencing neck pain for at least 2 months, with palpable taut bands in upper trapezius and SCM, active trigger points in upper trapezius, levator scapulae, and SCM, NPRS score >3/10 for neck region, and localized pain/stiffness in cervical spine (C3-C7) without upper limb radiculopathy, confirmed by negative Spurling's test, upper limb tension test, and shoulder abduction test. Subjects will be excluded if presented with a history of Participants who received myofascial treatment in the preceding month or have a diagnosis of fibromyalgia, KNGF Clinical Practice Guideline Grade III or IV, or neurological deficits.
Participants will be equally divided into 2 groups using a random number generator table. Group A will receive Active Release Technique, while Group B will receive Strain-Counterstrain. Both groups will also receive hot packs, superficial neck muscles stretching, and neck isometrics. Outcome measures, including the Numerical Pain Rating Scale for pain, goniometer for range of motion, cranio-vertebral angle measurement, Neck Disability Index, will be assessed at baseline and after four weeks. Ethical approval will be obtained from the Ethical Committee of Riphah International University, and informed consent will be secured from all participants. The outcomes will focus on pain intensity, cervical range of motion, cranio-vertebral angle, and disability, Data analysis will be performed using SPSS version 25. The findings are expected to provide valuable insights into the comparative efficacy of these manual therapy techniques, informing clinical practice and improving patient outcomes in the management of non-specific neck pain.
Read the detailed description
Neck discomfort is defined as pain that is felt anywhere along the posterior cervical spine, which runs from the superior nuchal line to the first thoracic spinous process. (According to IASP).The annual prevalence of neck pain varies widely over the world, from 30% to 50%. This can significantly impair the quality of life and disable individuals who are impacted.With the potential to significantly affect people, their families, communities, and healthcare systems, neck discomfort is regarded as the fourth most common disability in the world.
Neck pain is a prevalent musculoskeletal disorder affecting a significant portion of the global population at some point in their lives. It is estimated that up to 70% of people will experience neck pain during their lifetime. According to the global burden of disease in the Mediterranean region, the point prevalence of neck pain was estimated as 34.31 per 1000 in Pakistan.
Neck pain is often classified into specific and non-specific categories. Non-specific neck pain lacks a definitive cause and is frequently associated with poor posture, muscle strain, or minor injuries. It can become chronic, leading to prolonged discomfort and disability. Chronic neck pain affects daily activities, work performance, and overall well-being, making effective management essential.
In Pakistan, the prevalence of non-specific neck pain mirrors global trends, affecting a considerable portion of the population. Studies indicate that around 34% of the population in Pakistan experiences non-specific neck pain, driven by factors such as sedentary lifestyles, poor posture, and ergonomic issues in workplaces.
The rationale for this study is grounded in the high prevalence and significant impact of neck pain on individuals' quality of life and overall well-being. Non-specific neck pain affects a considerable portion of the population, leading to chronic pain and disability. Current treatments, while effective, often vary in their outcomes, necessitating a comparison of different therapeutic techniques. This study focuses on comparing the effects of Active Release Technique and Strain-Counterstrain, two promising manual therapy approaches. To figure out their efficacy in reducing pain, improving range of motion, and enhancing postural alignment. By investigating these methods, this study seeks to provide novel insights into their comparative effectiveness, which has been underexplored.
The findings will inform clinical practice, potentially leading to more personalized and effective treatment plans. Additionally, the study aims to address the socioeconomic burden of neck pain by improving patient outcomes and reducing healthcare costs. Through rigorous methodology and comprehensive analysis, this research aspires to contribute significantly to the field of manual physical therapy and enhance the management of non-specific neck pain.
- Conditions
- Neck Pain
- Being tested
- Active Release Technique, Strain-counterstrain
- Keywords
- Neck Pain, Soft Tissue Therapy, Trigger points, Cervicalgia, Posterior Cervical Pain
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Active Release TechniqueOther
Patients will receive Active Release Technique (ART) protocol will be applied to 4 muscles Including; trapezius, levator scapulae, sternocleidomastoid (SCM), and suboccipital muscles (for 15 minutes)
Strain-counterstrainOther
Patients will receive Strain-counterstrain (SCS) protocol will be applied to 4 muscles Including the trapezius, levator scapulae, sternocleidomastoid (SCM), and suboccipital muscles for 15 minutes.
| Study group | Role | What they receive |
|---|---|---|
| Treatment Group A | Experimental | Active Release Technique Receives: Other: Active Release Technique |
| Treatment Group B | Active comparator | Strain-counterstrain Receives: Other: Strain-counterstrain |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Pain rating Scale
Measured: Baseline, 4th Week
Neck Disability Index
Measured: Baseline, 4th Week
Craniovertebral Angle
Measured: Baseline, 4th Week
Cervical Range of Motion
Measured: Baseline, 4th Week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Jun 2025
- Study start1 May 2025
- Primary completion30 Aug 2025 (estimated)
- Study completion28 Sep 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Neck PainStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Syed Shakil ur Rehman, PhD, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07026006
- Sponsor's protocol ID
- Junad- REC/RCR&AHS 24/0141
- Status last verified
- Jun 2025
- First submitted
- 11 Jun 2025
- Last updated
- 18 Jun 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
de Campos TF, Maher CG, Steffens D, Fuller JT, Hancock MJ. Exercise programs may be effective in preventing a new episode of neck pain: a systematic review and meta-analysis. J Physiother. 2018 Jul;64(3):159-165. doi: 10.1016/j.jphys.2018.05.003. Epub 2018 Jun 19.
PubMed 29908853Cabrera-Martos I, Rodriguez-Torres J, Lopez-Lopez L, Prados-Roman E, Granados-Santiago M, Valenza MC. Effects of an active intervention based on myofascial release and neurodynamics in patients with chronic neck pain: a randomized controlled trial. Physiother Theory Pract. 2022 Sep;38(9):1145-1152. doi: 10.1080/09593985.2020.1821418. Epub 2020 Sep 15.
PubMed 32930638
Study at a glance
From the registry record, last updated by the sponsor on 18 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Active Release Versus Strain-Counter-strain Technique on Pain, Range of Motion, Cranio-vertebral Angle, and Disability in Patients With Non-Specific Neck Pain
- ClinicalTrials.gov ID
- NCT07026006
- Acronym / sponsor ID
- Junad- REC/RCR&AHS 24/0141
- Conditions
- Neck Pain
- Keywords
- Neck Pain, Soft Tissue Therapy, Trigger points, Cervicalgia, Posterior Cervical Pain
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 1 May 2025 (actual)
- Primary completion
- 30 Aug 2025 (estimated)
- Study completion
- 28 Sep 2025 (estimated)
- First posted
- 18 Jun 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The study design will be a randomized clinical trial (RCT) aims to compare the effects of Active Release Technique and Strain-Counterstrain on pain, range of motion, cranio-vertebral angle, and disability in patients with non-specific neck pain. Data will be collected from Safi Teaching Hospital, Faisalabad, Pakistan. Using a non-probability purposive sampling method, participants aged 18-45 years with localized cervical pain and stiffness will be selected based on inclusion and exclusion criteria. The inclusion and exclusion criteria will be; Participants aged 18-45, both male and female, experiencing neck pain for at least 2 months, with palpable taut bands in upper trapezius and SCM, active trigger points in upper trapezius, levator scapulae, and SCM, NPRS score >3/10 for neck region, and localized pain/stiffness in cervical spine (C3-C7) without upper limb radiculopathy, confirmed by negative Spurling's test, upper limb tension test, and shoulder abduction test. Subjects will be excluded if presented with a history of Participants who received myofascial treatment in the preceding month or have a diagnosis of fibromyalgia, KNGF Clinical Practice Guideline Grade III or IV, or neurological deficits.
Participants will be equally divided into 2 groups using a random number generator table. Group A will receive Active Release Technique, while Group B will receive Strain-Counterstrain. Both groups will also receive hot packs, superficial neck muscles stretching, and neck isometrics. Outcome measures, including the Numerical Pain Rating Scale for pain, goniometer for range of motion, cranio-vertebral angle measurement, Neck Disability Index, will be assessed at baseline and after four weeks. Ethical approval will be obtained from the Ethical Committee of Riphah International University, and informed consent will be secured from all participants. The outcomes will focus on pain intensity, cervical range of motion, cranio-vertebral angle, and disability, Data analysis will be performed using SPSS version 25. The findings are expected to provide valuable insights into the comparative efficacy of these manual therapy techniques, informing clinical practice and improving patient outcomes in the management of non-specific neck pain.
Detailed description
Neck discomfort is defined as pain that is felt anywhere along the posterior cervical spine, which runs from the superior nuchal line to the first thoracic spinous process. (According to IASP).The annual prevalence of neck pain varies widely over the world, from 30% to 50%. This can significantly impair the quality of life and disable individuals who are impacted.With the potential to significantly affect people, their families, communities, and healthcare systems, neck discomfort is regarded as the fourth most common disability in the world.
Neck pain is a prevalent musculoskeletal disorder affecting a significant portion of the global population at some point in their lives. It is estimated that up to 70% of people will experience neck pain during their lifetime. According to the global burden of disease in the Mediterranean region, the point prevalence of neck pain was estimated as 34.31 per 1000 in Pakistan.
Neck pain is often classified into specific and non-specific categories. Non-specific neck pain lacks a definitive cause and is frequently associated with poor posture, muscle strain, or minor injuries. It can become chronic, leading to prolonged discomfort and disability. Chronic neck pain affects daily activities, work performance, and overall well-being, making effective management essential.
In Pakistan, the prevalence of non-specific neck pain mirrors global trends, affecting a considerable portion of the population. Studies indicate that around 34% of the population in Pakistan experiences non-specific neck pain, driven by factors such as sedentary lifestyles, poor posture, and ergonomic issues in workplaces.
The rationale for this study is grounded in the high prevalence and significant impact of neck pain on individuals' quality of life and overall well-being. Non-specific neck pain affects a considerable portion of the population, leading to chronic pain and disability. Current treatments, while effective, often vary in their outcomes, necessitating a comparison of different therapeutic techniques. This study focuses on comparing the effects of Active Release Technique and Strain-Counterstrain, two promising manual therapy approaches. To figure out their efficacy in reducing pain, improving range of motion, and enhancing postural alignment. By investigating these methods, this study seeks to provide novel insights into their comparative effectiveness, which has been underexplored.
The findings will inform clinical practice, potentially leading to more personalized and effective treatment plans. Additionally, the study aims to address the socioeconomic burden of neck pain by improving patient outcomes and reducing healthcare costs. Through rigorous methodology and comprehensive analysis, this research aspires to contribute significantly to the field of manual physical therapy and enhance the management of non-specific neck pain.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Treatment Group A | Experimental | Other: Active Release TechniqueActive Release Technique |
| Treatment Group B | Active comparator | Other: Strain-counterstrainStrain-counterstrain |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (10 listed)
- Age 18-45 years
- Both male and female
- Patients with neck pain for at least 2 months
- Palpable taut bands in upper trapezius, SCM
- ATrPs in upper trapezius, levator scapulae, SCM
Key exclusion criteria (7 listed)
- Myofascial treatment in the preceding month
- Diagnosis of fibromyalgia
- Congenital problems
- Trigger point injections
- Individuals with KNGF Clinical Practice Guideline Grade III and IV severity of neck pain
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Active Release TechniquePatients will receive Active Release Technique (ART) protocol will be applied to 4 muscles Including; trapezius, levator scapulae, sternocleidomastoid (SCM), and suboccipital muscles (for 15 minutes) | Other | Treatment Group A |
| Strain-counterstrainPatients will receive Strain-counterstrain (SCS) protocol will be applied to 4 muscles Including the trapezius, levator scapulae, sternocleidomastoid (SCM), and suboccipital muscles for 15 minutes. | Other | Treatment Group B |
Primary outcome
Numeric Pain rating Scale
Time frame: Baseline, 4th Week
Neck Disability Index
Time frame: Baseline, 4th Week
Craniovertebral Angle
Time frame: Baseline, 4th Week
Cervical Range of Motion
Time frame: Baseline, 4th Week
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Jun 2025.
- Background: PubMed 29908853de Campos TF, Maher CG, Steffens D, Fuller JT, Hancock MJ. Exercise programs may be effective in preventing a new episode of neck pain: a systematic review and meta-analysis. J Physiother. 2018 Jul;64(3):159-165. doi: 10.1016/j.jphys.2018.05.003. Epub 2018 Jun 19.
- Background: PubMed 32930638Cabrera-Martos I, Rodriguez-Torres J, Lopez-Lopez L, Prados-Roman E, Granados-Santiago M, Valenza MC. Effects of an active intervention based on myofascial release and neurodynamics in patients with chronic neck pain: a randomized controlled trial. Physiother Theory Pract. 2022 Sep;38(9):1145-1152. doi: 10.1080/09593985.2020.1821418. Epub 2020 Sep 15.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Syed Shakil ur Rehman, PhD principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Active Release Technique and Strain-counterstrain in people with Neck Pain, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 18 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Syed Shakil ur Rehman, PhD (+92 320 786661, shakil.urrehman@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Pain rating Scale (time frame: Baseline, 4th Week). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07026006, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Jun 2025.