Strain-counterstrain versus Graston technique for quadratus lumborum trigger points

Comparative Effects of Strain Counterstrain Technique and Graston Technique on Trigger Points of Quadratus Lumborum Among Patients With Nonspecific Low Back Pain

This will test whether strain-counterstrain or the Graston technique reduces quadratus lumborum trigger point pain in adults 20–45 with nonspecific low back pain.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 34 (estimated)
• Ages: 20 Years to 45 Years
• Sex: All
• Sponsor: Riphah International University (other)
• Locations: 1 site (Lahore, Punjab Province)
• Trial ID: NCT06986707 on ClinicalTrials.gov

What this trial studies

Researchers will randomize 34 adults aged 20–45 with nonspecific chronic low back pain and quadratus lumborum trigger points to receive either strain-counterstrain or Graston technique at Riphah Rehabilitation Clinic and SPARC Physiotherapy Clinic in Lahore. Treatments and outcomes will be recorded at baseline and after four weeks, with pain, tenderness, and segmental mobility measured and data analyzed using SPSS v25. Participants are recruited by non-probability convenience sampling and all sessions are delivered in person. The trial directly compares two manual soft-tissue approaches to see which more effectively reduces trigger point symptoms and restores mobility.

Who should consider this trial

Good fit: Adults 20–45 years with at least 12 weeks of nonspecific low back pain, localized tenderness at quadratus lumborum trigger points, positive L4–L5 segmental mobility findings, and moderate pain on the NPRS.

Not a fit: Patients with specific spinal pathology (for example disc herniation, spinal deformity), recent spinal or orthopedic surgery, vertebral fracture, acute muscle trauma, active infection, or bleeding/anticoagulation conditions are excluded and unlikely to benefit from these techniques.

Why it matters

Potential benefit: If successful, it could offer a simple clinic-based manual therapy option to reduce pain and improve back mobility for patients with quadratus lumborum trigger points.

How similar studies have performed: Prior randomized trials of instrument-assisted soft tissue mobilization and kinesiotaping have shown improvements in pain and function for chronic mechanical low back pain, but direct comparisons between strain-counterstrain and Graston on quadratus lumborum trigger points are limited.

Eligibility criteria

Inclusion Criteria:

* Participant's age range 20-45 years
* Both genders.
* Individuals having low back pain for atleast 12 weeks with limited segmental mobility especially after maintaining certain prolonged posture .
* Individuals with localized pain and tenderness at attachments of quadratus lumborum due to the presence of trigger points (unilateral or bilateral).
* positive segmental mobility assessment at the level of L4 and L5 on one side or on both sides
* Patients having moderate pain on NPRS

Exclusion Criteria:

* Individuals with anticoagulation or bleeding disorders, acute muscle trauma, infections, lumbar disc herniation, spinal deformities, or a history of spinal surgery or anticoagulation medication
* Orthopedic surgery or any other low back surgery .
* Fracture of vertebrae and any lower limb injury

Where this trial is running

Lahore, Punjab Province

• Kishwar sultana hospital — Lahore, Punjab Province, Pakistan (RECRUITING)

Study contacts

• Principal investigator: Hira Shaukat, TDPT — Riphah International University
• Study coordinator: Imran Amjad, phD

Conditions: Trigger Point Pain, Myofascial, low back pain, quadratus lumborum