Evaluating Pain and Functional Outcomes of Active Release Technique Versus Strain-counter- Stain in Chronic Low Back Pain .A Randomized Clinical Trial

Chronic low back pain (CLBP) is a globally prevalent and debilitating condition that significantly impacts patients' functional capacity, quality of life, work productivity, and healthcare systems. Its multifactorial etiology, varied patient presentations, and inconsistent responses to treatment make CLBP a persistent therapeutic challenge. Non-pharmacological approaches such as Active Release Technique (ART) and Strain-Counter-Strain (SCS) have emerged as promising interventions, yet there is limited and inconsistent high-quality evidence comparing their effectiveness in CLBP management.

ART is a soft tissue manual therapy targeting myofascial adhesions, scar tissue, and trigger points. By applying specific manual pressure combined with patient movement, ART aims to restore normal muscle texture, reduce tension, and improve function. It is commonly used for pain associated with muscle tightness, restricted mobility, and neuromuscular dysfunction.

SCS is a passive positional release technique that reduces muscle spasm and tension by placing the affected muscle in a shortened position for a set duration, typically 90 seconds, followed by a gradual return to neutral. It works by reducing proprioceptive activity in muscle spindles, thereby alleviating pain and restoring motion.

This randomized clinical trial will recruit 40 male participants aged 30-45 years diagnosed with CLBP persisting for at least 3-4 months, with pain intensity ≥4/10 on the Visual Analogue Scale (VAS). Patients will be randomly allocated into two equal groups-Group A: ART and Group B: SCS-using a sealed card draw method. Both groups will receive a standardized pre-treatment protocol consisting of a 10-minute hot pack application to the lower back and 15 minutes of interferential current therapy.

Intervention Protocol: