The AAO Journal, 2023/06, 33(2):34. doi: 10.53702/2375-5717-33.2.20, type of study: ,ppt,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://meridian.allenpress.com/aaoj/article/33/2/20/493544/LBORC-NUFA-Poster-Abstracts-2023-Students)

Keywords:

cervical spine [320]
chronic pain [324]
neck pain [180]
OMT [3925]
osteopathic manipulative treatment [3946]
pretest posttest design [241]
range of motion [116]

Abstract:

Introduction/Background: Chronic neck pain is characterized by hyperalgesia of the skin, ligaments, and muscles; making it difficult to treat. Counterstrain techniques minimize the pain experienced during treatment, however, studies demonstrating counterstrain efficacy in this population are limited. Hypothesis: Counterstrain will reduce neck pain intensity, tenderpoint burden, and improve cervical range of motion (ROM) acutely and after three OMT sessions. Methods: IRB approval was obtained (MWU#22010) and four subjects with chronic neck pain completed the single subject design study. Cervical ROM and tenderpoint burden were assessed. Subjects received OMT using counterstrain 1x/wk for 3 weeks with measures obtained on 2 baseline sessions, after the first treatment, and 2 days and 1 week after the last treatment. Neck Disability Index and neck pain were measured at baseline and the last day. Data analysis was a mixed effects model for each dependent variable (pain, tenderpoint burden, ROM). Results: Tenderpoint burden was reduced acutely from 94.0±16.8 total tenderpoint summation to 31.5±10.8 (p=0.125); and 2 days after the last OMT session 51.5±18.8 (p=0.125). Reductions remained durable 1 week after treatment 49.3±19.6 (p=0.125). ROM was improved at all time points following OMT across all motion directions (p=0.039). Subjective disability improved by an average of 6 points; neck pain was reduced by an average of 1 point which did not exceed the minimally clinically important difference. Conclusion: OMT counterstrain was effective in improving tenderpoint burden, cervical ROM, and perceived disability in individuals with chronic neck pain. A limitation was low sample size. Future studies could incorporate ultrasound measures to provide additional quantitative assessments for OMT efficacy and mechanisms of response.