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Effect of Counterstrain Treatment on Contralateral Satellite Tender Points

Journal: The Journal of the American Osteopathic Association Date: 2012/08, 112(8):Pages: 532-533. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2012.112.8.529/html)

Keywords:

counterstrain [59]
randomized controlled trial [889]
shoulder [124]
tender points [15]

Abstract:

Background: It follows from the osteopathic tenet of body unity that treating somatic dysfunction on 1 side of the spine would diminish pain experienced on the other, and we have observed this to be true in patients complaining of bilateral muscle pain. Objective: To determine whether treating an active posterior shoulder tender point (TP) with counterstrain (CS) would similarly influence the contralateral anatomic site. Methods: In our mixed-model, randomized controlled trial, 51 adult volunteer participants were randomized to either the CS or sham arm. A brief osteopathic structural examination was performed, followed by an assessment of the trapezius and levator scapulae muscles for TPs. When an “active” TP was palpated, the site was marked, and a symmetric “quiescent” TP was found and marked on the contralateral side. A blinded researcher then applied a pressure algometer (JTech Medical, Salt Lake City, Utah) to assess the pressure pain thresholds (PPT) of both points. The treatment group received standard CS treatment at the active TP, and the sham group received a simulated treatment over the area. After the CS or sham intervention, the active and quiescent points were both remeasured with the algometer. Results: Participants in the CS arm (n=25) had a mean (standard deviation [SD]) PPT of 4.09 (1.55) in the active TP pretreatment, which significantly increased to 5.41 (1.90) posttreatment. This corresponds to a mean (SD) PPT of 5.95 (1.94) in the quiescent TP pretreatment, which increased to 5.99 (2.14) after treating the active site, but this was not statistically significant. Participants in the sham arm (n=26) had a mean PPT of 5.04 (1.81) in the active TP preintervention, which significantly increased to 5.93 (1.93) after intervention. The quiescent side had a preintervention mean (SD) PPT of 6.44 (2.04), with a postintervention mean (SD) of 6.42 (1.66), however, this does not represent a statistically significant change. Conclusion: Counterstrain treatment of an active TP on 1 side of the body did not have an appreciable effect on the contralateral anatomic site in the population we studied. Interestingly, both the CS and sham arms showed a significantly increased PPT following intervention, which could be due to placebo effect or simply the inherent therapeutic value of human touch.


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