Cervical PainNCT07725861
Strain Counter Strain With and Without Sustained Natural Aphophyseal Glide in Non Specific Neck Pain
A study testing Strain Counterstrain + SNAG with Common Treatment and Strain Counterstain (SCS) only in people with Cervical Pain, run by Riphah International University at 1 site in Pakistan.
Trial 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. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Cervical Pain
- What is being tested?
- Strain Counterstrain + SNAG with Common Treatment and Strain Counterstain (SCS) only
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 68 participants
- Where
- 1 sitePakistan
- Study dates
- 20 Jun 2026to 20 Sep 2026
- 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 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- •Both Males and Females (20)
- Age 18 and 60 years
- pain intensity 3-6 rating on NPRS
- Pain localized to cervical or upper trapezius
Who cannot join
- • Cervical radiculopathy(20)
- History of whiplash injury
- History of cervical and thoracic spine surgery
- Neck pain associated with vertigo(20)
- History of spinal osteoporosis
- Vertebral Fractures
- Tumours
- Diagnosed psychological disorders
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
Ibne sina hospital and research institute.
Multan, Punjab Province
Sajad Rashid, MS-OMPT, 0300 6309825, sajidch71@hotmail.com
About this study
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
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.
Read the detailed description
This study will be a randomized clinical trial and will take place at Ibne Sina Hospital in Multan. Patients will be chosen using convenience sampling. Those who meet the required conditions will be randomly divided into two groups using a computer program. Group A will receive the SCS and SNAG technique , while Group B will receive SCS alone . Treatment will be given three times a week for four weeks The outcomes will be measured before and after the treatment. These include: Pain (measured using the NPRS Scale ,Neck movement (measured with a goniometer), Craniovertebral angle (checked using digital photos) ,Disability level (measured using the Neck Disability Index - NDI) . The collected data will be analyzed using SPSS version 21. First, the normality of the data will be checked using the Shapiro-Wilk test. Based on the results, suitable statistical tests will be used to compare the results within and between the groups.
- Conditions
- Cervical Pain
- Being tested
- Strain Counterstrain + SNAG with Common Treatment, Strain Counterstain (SCS) only
- Medical subject headings
- Neck Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Strain Counterstrain + SNAG with Common TreatmentOther
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) onlyOther
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).
| Study group | Role | What they receive |
|---|---|---|
| Strain Counterstrain + SNAG with Common Treatment | Experimental | Strain-Counterstrain (SCS) and SNAGs (Sustained Natural Apophyseal Glides) are two highly effective, non-invasive manual therapy techniques used to relieve neck pain. SCS gently relaxes hyperactive muscles by placing the body in a pain-free position, while SNAGs are movement-based mobilizations that restore joint function and reduce pain Receives: Other: Strain Counterstrain + SNAG with Common Treatment |
| Strain Counterstain (SCS) only | Active comparator | Strain-Counterstrain (SCS) is a gentle, passive osteopathic technique that treats neck pain by finding tender points and holding the neck in a highly specific "position of ease" for 90 seconds. This shortens the affected, spasming muscle, allowing the nervous system to reset muscle spindles and break the pain Receives: Other: Strain Counterstain (SCS) only |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric pain rate scale (NPRS)
Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain".(25) NPRS shows strong construct validity and correlates well with other pain scales like the Visual Analog Scale (VAS) and McGill Pain Questionnaire. It is especially useful for tracking changes in pain over time.(13) The NPRS demonstrates excellent test-retest reliability with an intraclass correlation coefficient (ICC) of ~0.95 in patients with chronic musculoskeletal pain.(26) The MCID for NPRS is generally considered to be 2 points, meaning a change of 2 or more points is considered clinically meaningful in musculoskeletal pain patients
Measured: upto 4 weeks
Neck Disability index (NDI)
This questionnaire will be used to assess disability. It comprises of 10 items; 7 related to daily living activities, 2 related to pain and 1 related to concentration. Each item is scored from 0 to 5. Total score is expressed as a percentage, with higher scores related to greater disability(28) Its construct validity has been supported through correlations with pain intensity, cervical range of motion, and quality-of-life measures (13). It shows excellent test retest reliability, with an ICC of 0.89-0.98 in patients with mechanical or non-specific neck pain (26)The Minimal Detectable Change (MDC) for NDI has been reported to be 5 points, while the MCID is commonly considered to be around 7-10 points for clinical relevance in chronic musculoskeletal pain
Measured: Upto 4 weeks
Universal Goniometer (UG)
It will measure range of motion of neck (29) A universal goniometer will be used to measure active cervical range of motion (CROM) in flexion, extension, lateral flexion, and rotation. This tool is portable, affordable, and easy to use in clinical and research settings.
The validity of goniometry in measuring cervical ROM has been confirmed through comparisons with CROM devices and motion sensors, showing strong correlations (r > 0.85) in neck mobility measurement (27).
Goniometer-based cervical ROM assessments demonstrate good to excellent reliability, with ICC values ranging from 0.79 to 0.96, depending on the plane of movement and rater experience
Measured: Upto 4 weeks
Craniovertebral Angle (CVA)
It is used to measure the degree of forward head posture, which is common in people with neck pain. A smaller CVA indicates a more forward head position, while a larger angle reflects a more neutral, healthy posture .To measure CVA, a lateral photograph is taken while the patient stands in a relaxed position. The angle is formed between a horizontal line passing through the C7 vertebra and a line connecting C7 to the tragus of the ear. This measurement is usually done using image analysis software or mobile applications like Posture Screen or ImageJ. Studies have shown that CVA measurement is a reliable and valid method for assessing head posture. It has good intra-rater and inter-rater reliability, with Intraclass Correlation Coefficients (ICC) ranging from 0.88 to 0.98 (8, 15).The Minimal Detectable Change (MDC) for CVA varies across studies but is generally estimated to be about 3-4 degrees, making it a sensitive tool for detecting postural improvements
Measured: Upto 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Jul 2026
- Study start20 Jun 2026
- Primary completion20 Aug 2026 (estimated)
- Study completion20 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for Cervical 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
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 68 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Amna Zia, PhD*, Principal investigator, Riphah International University, LahoreHadeel Mukhtar, Principal investigator, Riphah International University, Lahore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07725861
- Sponsor's protocol ID
- REC/RCR&AHS/25/0133 Hadeel
- Status last verified
- Jul 2026
- First submitted
- 21 Jul 2026
- Last updated
- 24 Jul 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Barbosa-Silva J, Luc A, Sobral de Oliveira-Souza AI, Martins de Abreu R, Cipriano J, de Schaetzen M, Pitance L, Armijo-Olivo S. The Effectiveness of Mulligan's Techniques in Non-Specific Neck Pain: A Systematic Review and Meta-Analysis. Physiother Res Int. 2025 Jul;30(3):e70045. doi: 10.1002/pri.70045.
PubMed 40439260Blanpied PR, Gross AR, Elliott JM, Devaney LL, Clewley D, Walton DM, Sparks C, Robertson EK. Neck Pain: Revision 2017. J Orthop Sports Phys Ther. 2017 Jul;47(7):A1-A83. doi: 10.2519/jospt.2017.0302.
PubMed 28666405de Koning CH, van den Heuvel SP, Staal JB, Smits-Engelsman BC, Hendriks EJ. Clinimetric evaluation of active range of motion measures in patients with non-specific neck pain: a systematic review. Eur Spine J. 2008 Jul;17(7):905-21. doi: 10.1007/s00586-008-0656-3. Epub 2008 Apr 22.
PubMed 18427843Shukla Yu, Shah D. Effect of Craniocervical Flexion Training in Mechanical Neck Pain on Proprioception, Endurance and Pain -An Interventional Study. International Journal of Health Research. 2020;Vol.5:565.
Raja G P, Bhat N S, Fernandez-de-Las-Penas C, Gangavelli R, Davis F, Shankar R, Prabhu A. Effectiveness of deep cervical fascial manipulation and yoga postures on pain, function, and oculomotor control in patients with mechanical neck pain: study protocol of a pragmatic, parallel-group, randomized, controlled trial. Trials. 2021 Aug 28;22(1):574. doi: 10.1186/s13063-021-05533-w.
PubMed 34454582Bernal-Utrera C, Gonzalez-Gerez JJ, Anarte-Lazo E, Rodriguez-Blanco C. Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial. Trials. 2020 Jul 28;21(1):682. doi: 10.1186/s13063-020-04610-w.
PubMed 32723399Cerezo-Tellez E, Torres-Lacomba M, Mayoral-Del-Moral O, Pacheco-da-Costa S, Prieto-Merino D, Sanchez-Sanchez B. Health related quality of life improvement in chronic non-specific neck pain: secondary analysis from a single blinded, randomized clinical trial. Health Qual Life Outcomes. 2018 Nov 6;16(1):207. doi: 10.1186/s12955-018-1032-6.
PubMed 30400984Shamsi S, Alyazedi FM, Abdelkader SM, Khan S, Akhtar A. Efficacy of Sustained Natural Apophyseal Glides in the Management of Mechanical Neck Pain: A Randomized Clinical Trial. Indian Journal of Medical Specialities. 2021;12(4):199-206.
Al Shehri A, Khan S, Shamsi S, Almureef SS. Comparative study of mulligan (snags) and maitland mobilization in neck pain. European Journal of Physical Education and Sport Science. 2018.
Prayerna B, SuBBiah K, Asser P, MiLaneSe S. Effectiveness of mulligan's sustained natural apophyseal glide (SNAG) over first rib in reducing pain and improving cervical rotation in individuals with mechanical neck dysfunction. Journal of Clinical & Diagnostic Research. 2019;13(3)
Study at a glance
From the registry record, last updated by the sponsor on 24 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- 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
- ClinicalTrials.gov ID
- NCT07725861
- Acronym / sponsor ID
- REC/RCR&AHS/25/0133 Hadeel
- Conditions
- Cervical Pain
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 68 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 20 Jun 2026 (actual)
- Primary completion
- 20 Aug 2026 (estimated)
- Study completion
- 20 Sep 2026 (estimated)
- First posted
- 24 Jul 2026 (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.
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.
Detailed description
This study will be a randomized clinical trial and will take place at Ibne Sina Hospital in Multan. Patients will be chosen using convenience sampling. Those who meet the required conditions will be randomly divided into two groups using a computer program. Group A will receive the SCS and SNAG technique , while Group B will receive SCS alone . Treatment will be given three times a week for four weeks The outcomes will be measured before and after the treatment. These include: Pain (measured using the NPRS Scale ,Neck movement (measured with a goniometer), Craniovertebral angle (checked using digital photos) ,Disability level (measured using the Neck Disability Index - NDI) . The collected data will be analyzed using SPSS version 21. First, the normality of the data will be checked using the Shapiro-Wilk test. Based on the results, suitable statistical tests will be used to compare the results within and between the groups.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Strain Counterstrain + SNAG with Common Treatment | Experimental | Other: Strain Counterstrain + SNAG with Common TreatmentStrain-Counterstrain (SCS) and SNAGs (Sustained Natural Apophyseal Glides) are two highly effective, non-invasive manual therapy techniques used to relieve neck pain. SCS gently relaxes hyperactive muscles by placing the body in a pain-free position, while SNAGs are movement-based mobilizations that restore joint function and reduce pain |
| Strain Counterstain (SCS) only | Active comparator | Other: Strain Counterstain (SCS) onlyStrain-Counterstrain (SCS) is a gentle, passive osteopathic technique that treats neck pain by finding tender points and holding the neck in a highly specific "position of ease" for 90 seconds. This shortens the affected, spasming muscle, allowing the nervous system to reset muscle spindles and break the pain |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- •Both Males and Females (20)
Key exclusion criteria (8 listed)
- • Cervical radiculopathy(20)
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 |
|---|---|---|
| Strain Counterstrain + SNAG with Common TreatmentGroup 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 | Other | Strain Counterstrain + SNAG with Common Treatment |
| Strain Counterstain (SCS) onlyGroup 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). | Other | Strain Counterstain (SCS) only |
Primary outcome
Numeric pain rate scale (NPRS)
Time frame: upto 4 weeks
Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain".(25) NPRS shows strong construct validity and correlates well with other pain scales like the Visual Analog Scale (VAS) and McGill Pain Questionnaire. It is especially useful for tracking changes in pain over time.(13) The NPRS demonstrates excellent test-retest reliability with an intraclass correlation coefficient (ICC) of ~0.95 in patients with chronic musculoskeletal pain.(26) The MCID for NPRS is generally considered to be 2 points, meaning a change of 2 or more points is considered clinically meaningful in musculoskeletal pain patients
Neck Disability index (NDI)
Time frame: Upto 4 weeks
This questionnaire will be used to assess disability. It comprises of 10 items; 7 related to daily living activities, 2 related to pain and 1 related to concentration. Each item is scored from 0 to 5. Total score is expressed as a percentage, with higher scores related to greater disability(28) Its construct validity has been supported through correlations with pain intensity, cervical range of motion, and quality-of-life measures (13). It shows excellent test retest reliability, with an ICC of 0.89-0.98 in patients with mechanical or non-specific neck pain (26)The Minimal Detectable Change (MDC) for NDI has been reported to be 5 points, while the MCID is commonly considered to be around 7-10 points for clinical relevance in chronic musculoskeletal pain
Universal Goniometer (UG)
Time frame: Upto 4 weeks
It will measure range of motion of neck (29) A universal goniometer will be used to measure active cervical range of motion (CROM) in flexion, extension, lateral flexion, and rotation. This tool is portable, affordable, and easy to use in clinical and research settings. The validity of goniometry in measuring cervical ROM has been confirmed through comparisons with CROM devices and motion sensors, showing strong correlations (r > 0.85) in neck mobility measurement (27). Goniometer-based cervical ROM assessments demonstrate good to excellent reliability, with ICC values ranging from 0.79 to 0.96, depending on the plane of movement and rater experience
Craniovertebral Angle (CVA)
Time frame: Upto 4 weeks
It is used to measure the degree of forward head posture, which is common in people with neck pain. A smaller CVA indicates a more forward head position, while a larger angle reflects a more neutral, healthy posture .To measure CVA, a lateral photograph is taken while the patient stands in a relaxed position. The angle is formed between a horizontal line passing through the C7 vertebra and a line connecting C7 to the tragus of the ear. This measurement is usually done using image analysis software or mobile applications like Posture Screen or ImageJ. Studies have shown that CVA measurement is a reliable and valid method for assessing head posture. It has good intra-rater and inter-rater reliability, with Intraclass Correlation Coefficients (ICC) ranging from 0.88 to 0.98 (8, 15).The Minimal Detectable Change (MDC) for CVA varies across studies but is generally estimated to be about 3-4 degrees, making it a sensitive tool for detecting postural improvements
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 24 Jul 2026.
- Background: PubMed 40439260Barbosa-Silva J, Luc A, Sobral de Oliveira-Souza AI, Martins de Abreu R, Cipriano J, de Schaetzen M, Pitance L, Armijo-Olivo S. The Effectiveness of Mulligan's Techniques in Non-Specific Neck Pain: A Systematic Review and Meta-Analysis. Physiother Res Int. 2025 Jul;30(3):e70045. doi: 10.1002/pri.70045.
- Background: PubMed 28666405Blanpied PR, Gross AR, Elliott JM, Devaney LL, Clewley D, Walton DM, Sparks C, Robertson EK. Neck Pain: Revision 2017. J Orthop Sports Phys Ther. 2017 Jul;47(7):A1-A83. doi: 10.2519/jospt.2017.0302.
- Background: PubMed 18427843de Koning CH, van den Heuvel SP, Staal JB, Smits-Engelsman BC, Hendriks EJ. Clinimetric evaluation of active range of motion measures in patients with non-specific neck pain: a systematic review. Eur Spine J. 2008 Jul;17(7):905-21. doi: 10.1007/s00586-008-0656-3. Epub 2008 Apr 22.
- BackgroundShukla Yu, Shah D. Effect of Craniocervical Flexion Training in Mechanical Neck Pain on Proprioception, Endurance and Pain -An Interventional Study. International Journal of Health Research. 2020;Vol.5:565.
- Background: PubMed 34454582Raja G P, Bhat N S, Fernandez-de-Las-Penas C, Gangavelli R, Davis F, Shankar R, Prabhu A. Effectiveness of deep cervical fascial manipulation and yoga postures on pain, function, and oculomotor control in patients with mechanical neck pain: study protocol of a pragmatic, parallel-group, randomized, controlled trial. Trials. 2021 Aug 28;22(1):574. doi: 10.1186/s13063-021-05533-w.
- Background: PubMed 32723399Bernal-Utrera C, Gonzalez-Gerez JJ, Anarte-Lazo E, Rodriguez-Blanco C. Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial. Trials. 2020 Jul 28;21(1):682. doi: 10.1186/s13063-020-04610-w.
- Background: PubMed 30400984Cerezo-Tellez E, Torres-Lacomba M, Mayoral-Del-Moral O, Pacheco-da-Costa S, Prieto-Merino D, Sanchez-Sanchez B. Health related quality of life improvement in chronic non-specific neck pain: secondary analysis from a single blinded, randomized clinical trial. Health Qual Life Outcomes. 2018 Nov 6;16(1):207. doi: 10.1186/s12955-018-1032-6.
- BackgroundShamsi S, Alyazedi FM, Abdelkader SM, Khan S, Akhtar A. Efficacy of Sustained Natural Apophyseal Glides in the Management of Mechanical Neck Pain: A Randomized Clinical Trial. Indian Journal of Medical Specialities. 2021;12(4):199-206.
- BackgroundAl Shehri A, Khan S, Shamsi S, Almureef SS. Comparative study of mulligan (snags) and maitland mobilization in neck pain. European Journal of Physical Education and Sport Science. 2018.
- BackgroundPrayerna B, SuBBiah K, Asser P, MiLaneSe S. Effectiveness of mulligan's sustained natural apophyseal glide (SNAG) over first rib in reducing pain and improving cervical rotation in individuals with mechanical neck dysfunction. Journal of Clinical & Diagnostic Research. 2019;13(3)
- 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.
Amna Zia, PhD* principal investigator
Riphah International University, Lahore
Hadeel Mukhtar principal investigator
Riphah International University, Lahore
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Strain Counterstrain + SNAG with Common Treatment and Strain Counterstain (SCS) only in people with Cervical 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 4 inclusion and 8 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 24 Jul 2026. 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 Amna Zia, PhD* (03244686993, amna.zia@kemu.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric pain rate scale (NPRS) (time frame: upto 4 weeks). 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 NCT07725861, which also lists 10 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 24 Jul 2026.