Spray and Stretch Technique Versus Strain Counter Strain in Patients With Non Specific Low Back Pain

July 27, 2026 updated by: Riphah International University

Comparative Effect of Spray and Stretch Technique Versus Strain Counter Strain on Hamstring Muscles for Pain , Disability and Mobility in Patients With Non Specific Low Back Pain

Non-specific low back pain refers to pain in the lower back region that cannot be attributed to a specific identifiable pathology such as infection, tumor, osteoporosis, lumbar disc herniation, spinal stenosis or fracture. It is the most common type of low back pain, accounting for about 85-90% of cases. Non specific low back pain is posteriorly occurring that is located between lower rib margin and gluteal fold. It is exacerbated by sustained back postures, back movements or back muscle imbalances. The aim of study is to find out which technique whether Spray and stretch technique or strain Counter strain works better in reducing pain ,improving movement ,and decreasing disability caused by tight hamstring muscles in people with non specific low Back Pain.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This double blinded randomized Clinical Trial will be conducted at Ibne Siena Hospital MULTAN through consecutive sampling technique on 30 patients which will be allocated using simple random sampling through sealed opaque enveloped into Group A and Group B. Group A will be treated with spray and stretch technique and Group B will be treated with strain counter technique at the frequency of 2 sets with 5 repetitions and thrice a week. Outcome measures will be conducted through NPRS, ODI, AKE ,PKET and SLR before treatment and after 4 weeks. Data will be analyzed during SPSS software version 26. After assessing normality of data by Shapiro-wilk test, it will be decided either parametric or non parametric test will be used within a group or between two groups.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
30

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

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Study Contact

Study Contact

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Study Contact Backup

Study Locations

  • Pakistan
    • Punjab Province
      • Multan, Punjab Province, Pakistan
        • Recruiting
        • Ibne sina hospital and research institute.
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • AGE(35 to 50)

    • Gender (both male and female)
    • Negative lasegue test
    • Negative slump test
    • Negative prone instability test

Exclusion Criteria:

  • Fracture or instability (4)

    • History of cancer
    • Inflammatory condition like ankylosing spondylitis
    • Neurological deficits like cauda equina syndrome or motor weakness
    • History of previous of previous lumber surgery
    • Pregnancy
    • Structural deformity like scoliosis
    • Herniated disc
    • Nerve compression
    • Spinal stenosis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Spray and stretch technique on Hamstrings muscle
The spray and stretch technique is a physical therapy method used to inactivate myofascial trigger points, reduce muscle spasms, and increase range of motion. It works by applying a vapocoolant spray to numb the skin, which interrupts the pain signal, allowing the therapist to safely stretch the muscle
Other: Spray and stretch technique on Hamstring Muscle

The participant will be positioned in a comfortable supine lying position on a treatment table in a quiet and suitable clinical environment. Before starting the intervention, the procedure will be explained to the participant in simple language, and verbal confirmation of comfort will be obtained. The affected lower limb will be exposed appropriately while ensuring privacy, modesty, and warmth through proper draping with towels or sheets. The participant will be instructed to relax the lower limb during the procedure. The hip will be maintained in a neutral position, and the knee will be kept straight or slightly flexed according to the participant's comfort before the stretching component begins.

The therapist will first inspect the posterior thigh region to ensure that the skin is intact and suitable for vapocoolant application. The presence of any open wound, skin infection, rash, hypersens
Active Comparator: Strain and counter strain technique on Hamstring muscle
Strain-Counterstrain (SCS) is a gentle, hands-on physical therapy technique used to relieve low back pain by "resetting" the nervous system. By placing the body in specific, pain-free positions, it relaxes tight muscles, reduces muscle guarding, and improves mobility
Other: Strain and counter strain technique on hamstring muscle
identify the tender point Palpate the hamstring while the patient is prone or side lying locate the most tender point in belly of the muscle or near the ischial tuberosity Establish a pain scale and Ask the patient to rate the tenderness from 0 to 10 (10 being the most painful).Position of ease will be achieved by Flexing the patient's knee to about 70 to 90 degrees .Slightly abduct and externally rotate the leg to shorten the hamstring muscle (the position may vary depending on the muscle .The goal is to reduce tenderness by at least 70% .Hold the position and Maintain this position of comfort for 90 seconds Encourage the patient to relax during this time .Return the leg passively to a neutral position to avoid reactivating the trigger point .Palpate the tender point again and ask for a new pain rating.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Numeric pain rate scale (NPRS)
Time Frame: Baseline and after 4 weeks of intervention
Pain intensity will be assessed using the 11-point Numeric Pain Rating Scale. Participants will rate their current low back pain from 0 to 10, where 0 indicates "no pain" and 10 indicates the "worst imaginable pain." The score will be recorded in points, with higher scores indicating greater pain intensity.
Baseline and after 4 weeks of intervention
Active knee extension
Time Frame: Baseline and after 4 weeks of intervention
Hamstring flexibility will be assessed using the Active Knee Extension Test. The participant will lie in the supine position with the hip flexed to 90 degrees and will actively extend the knee as far as possible while maintaining the hip position. The knee extension angle will be measured in degrees using a goniometer. A smaller knee-flexion deficit indicates greater hamstring flexibility.Positive AKE (For males, a positive knee extension angle is >33.0°, whereas for females, it is >24)
Baseline and after 4 weeks of intervention
Passive knee extension test (PKET)
Time Frame: Baseline and after 4 weeks
Hamstring flexibility will be assessed using the Passive Knee Extension Test. With the participant in the supine position and the hip maintained at 90 degrees of flexion, the examiner will passively extend the knee until resistance or discomfort is reached. The knee extension angle will be measured in degrees using a goniometer. A greater knee-extension angle indicates greater hamstring flexibility.
Baseline and after 4 weeks
Oswestry Disability Index
Time Frame: Baseline and after 4 weeks
Low back pain-related disability will be assessed using the Oswestry Disability Index. The questionnaire contains 10 sections, with each section scored from 0 to 5. The total score will be converted into a percentage ranging from 0% to 100%, where higher scores indicate greater disability.
Baseline and after 4 weeks
Straight leg raise
Time Frame: Baseline and after 4 weeks
Straight leg raise range of motion will be assessed with the participant in the supine position. The examiner will passively raise the participant's lower limb while maintaining the knee in extension until resistance or discomfort is reported. The hip-flexion angle will be measured in degrees using a goniometer. A greater angle indicates greater posterior-chain flexibility and straight leg raise range of motion.
Baseline and after 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Riphah International University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Amna Zia, PhD*, Riphah International University, Lahore
  • Principal Investigator: Zaib un Nisa, Riphah International University, Lahore

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 20, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 20, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 20, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 21, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 27, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 28, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 28, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 27, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • REC/RCR & AHS/25/0135 Nisa

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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