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NCT Number: NCT07729774

Spray and Stretch Technique Versus Strain Counter Strain 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.

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Key information

Conditions

Low Back Pain Back Pain Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

35 year–50 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ibne sina hospital and research institute.

Multan, Punjab Province, Pakistan

Location status: Recruiting

Location contact

Sajad Rasheed, MS-OMPT

CONTACT

[email protected]

0300 6309825

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Spray and stretch technique on Hamstring Muscle

Other

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

Strain and counter strain technique on hamstring muscle

Other

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.

Primary outcomes

  1. 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.

  2. 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)

  3. 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.

  4. 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.

  5. 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.

Study contacts

Contact information is provided by the study sponsor or research team.

Amna Zia, PhD*

CONTACT

[email protected]

03244686993

Samrood Akram, PhD*

CONTACT

[email protected]

03324806143

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

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

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jul 28, 2026
Registry last updated
Jul 28, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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