Effects of Sub Occipital Muscle Inhibition Technique in Mechanical Low Back Pain

Riphah International University

Status: Completed

Conditions: Mechanical Low Back Pain

Treatments: Other: Sub occipital muscle inhibition technique and conventional therapy; Other: conventional therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT06407206

REC OMAIRAH AIEN

Details and patient eligibility

About

The aim of study is to determine the effects of sub occipital muscle inhibition technique in mechanical low back pain, hamstring muscle flexibility, lumbar ranges and functional disability. This study will focus on either this technique have effects on reliving lumbar pain, improving flexibility of hamstring muscles and lumbar ranges or not.

Full description

Low back pain (LBP) is a common health condition, 70% of population of all ages is suffering from low back pain. Females have higher prevalence of low back pain than males. Individuals with low back pain experience muscle stiffness tension and pain in the back of body between the lower edge of 12th rib and the lower border of gluteal creases in the lumbo-sacral area (from L1-S1 vertebra) with a duration of more than three months. Low back pain can be mechanical in nature and is not associated with any other pathology .The primary etiological factors of mechanical low back pain is repetitive trauma and overuse.

Hamstring is a multi - joint muscle complex which consists of three muscles ( semitendinosus, semimembranosus and biceps femoris muscle) that covers the posterior thigh extending from ischial tuberosity to the medial and lateral aspects of the knee joint, performing flexion of knee and extension of hip joint. Hamstring muscle is prone to tightness, its flexibility have a vital role in maintaining the normal lumbar spine mechanics. Hamstring tightness is common among ages of 18-25 years with about 62% to 82% prevalence .Hamstring shortening during spinal flexion limits anterior pelvic tilting resulting in higher compressive loads on lumbar spine. It will place extreme pressure on lumbar extensors, involved in maintaining pelvic motion which will result in LBP .

Sub occipital muscle inhibition technique is a technique that results in relaxing the tense fascia and sub occipital muscles .It can be relaxed by applying pressure to sub occipital region while patient is lying in supine position. It is able to relax the fascia and results in increasing hamstring flexibility, which further results in reducing low back pain, increasing lumbar spine mobility and reducing functional limitations

Enrollment: 36 patients

Sex: All

Ages: 18 to 25 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Chronic mechanical low back pain > 12 weeks
• Patients with hamstring tightness having popliteal angle more than 30 degrees.
• Negative sacroiliac distraction test to exclude sacroiliac joint pain

Exclusion criteria

• Acute severe low back pain
• Patients with hamstring injury
• Active tumor or infection
• Fractures of cervical and lumbar spine
• History of previous lumbar, hip and knee surgery
• Migraine
• Fever
• Sacroiliac joint dysfunction
• Cauda equine syndrome
• Patients having cognitive or mental retardation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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36 participants in 2 patient groups

Sub occipital muscle inhibition technique along with conventional therapy

Experimental group

Description:

Patient is in supine position Therapist sits near the head of the participant and places his hand below the head of the participant With the pads of hand therapist palpates the arch of atlas between the occipital protuberance and spinous process of axis and place the middle and ring finger over it by flexing the metacarpophalangeal joint in 90 degrees of flexion, base of skull will rest on hands Pressure is exerted in upward direction towards the therapist and is maintained for two minutes so that the muscle scan relax Participants are guided to keep their eyes close in order to avoid movement which affects the tone of sub occipital muscle

Treatment:

Other: Sub occipital muscle inhibition technique and conventional therapy

conventional therapy

Other group

Description:

Transcutaneous electrical nerve stimulation at lower back and hamstring muscles (pulse rate: 4Hertz, pulse duration: 150µs for 15mins) Hot pack ( 15mins),Ankle pumps (15 reps with 5 sec hold), Knee Range of motions (flexion and extension,10 reps),Quadriceps set (10 reps,5 sec hold),Vastus Medialis oblique (10 reps 5 sec hold),Gluteus sets (10 reps, 5 sec hold),Single knee to chest (10 reps with 10 sec hold) McKenzie exercises (10 reps with 10 sec hold and 10 sec rest),Stretching of calf and hamstring muscles (passive stretching,7 reps with 5 sec hold).

Treatment:

Other: conventional therapy