Changes in pain, spasticity, and quality of life after use of Counterstrain Osteopathic Manipulative Treatment in individuals with Spinal Cord Injuries

Abstract

Spinal Cord Injury (SCI) patients experience interference in quality-of-life due to pain and spasticity. These symptoms could be attributed to an imbalance of agonist and antagonist muscles in muscle reflex arcs secondary to chronic nerve damage. Counterstrain Osteopathic Manipulative Treatment (OMT) modality can address these symptoms by rebalancing the agonist and antagonist muscles in these dysfunctional reflex arcs.

The objective of this single group pretest-posttest study is to analyze the effects of Counterstrain OMT on pain, spasticity, and quality of life of patients with SCI.

Methods

Participants were subjected to counterstrain OMT intervention of the anterior lumbar regions1-4, Iliacus, Psoas, Medial and Lateral Hamstring, Gastrocnemius and Soleus counterstrain tenderpoints. Pain and spasticity measures (Universal Pain Scale and Modified Ashworth Scale, respectively) were taken pre- and post-counterstrain OMT for all treatment sessions per participant with quality-of-life measures evaluated pre- and post-study using the Neuropathic Pain Diagnostic Questionnaire and SCI Spasticity Evaluation Tool. Paired-sample t-test data analyses were used to examine all pain and spasticity measures pre- and post-treatment and study.

Results

Counterstrain OMT was shown to be effective on all counterstrain tenderpoints treated for both pain and spasticity (p < 0.05). Longitudinally, counterstrain OMT was shown to improve pain on quality-of-life measures of activity (p = 0.003), mood (p = 0.011) and work (p = 0.013), and spasticity on quality-of-life measures of recreation (p = 0.045) and therapeutic exercise (p = 0.042).

Conclusion

This study provides evidence that counterstrain OMT can be an effective additional treatment to temporarily relieve pain and spasticity, which, in turn, may also improve the quality of life for individuals with SCI.