Neural Tension Technique Improves Immediate Conditioned Pain Modulation in Patients with Chronic Neck Pain: A Randomized Clinical Trial

Abstract

Objective: To determine the immediate effect of neural tension technique (NTT) on conditioned pain modulation in patients with chronic neck pain. A secondary objective was to determine the immediate effect of neural tensioner technique on pain intensity and cervical range of movement.

Design: Randomized clinical trial.

Setting: University medical center.

Subjects: Fifty-four patients with neck pain (13 males and 41 females; mean± SD age = 20.91 ± 2.64 years) were randomly allocated to two groups: NTT or sham technique.

Methods: Participants received a visual analog scale (VAS) and neck disability index (NDI) after inclusion. Conditioned pain modulation (CPM) and active cervical range of motion were measured before and after the intervention. Each subject received one treatment session.

Results: The results of the analysis of variance revealed a significant effect for the group × time interaction only for CPM (F = 11.09, P = 0.002, ηp2 = 0.176). No significant interactions were found for the other measures (VAS [F = 1.719, P = 0.195, ηp2 = 0.031], pressure pain threshold C2 [F = 0.731, P = 0.398, ηp2 = 0.018], flexion [F = 0.176, P = 0.677, ηp2 = 0.003], extension [F = 0.035, P = 0.852, ηp2 = 0.001], lateral flexions [F = 0.422, P = 0.519, ηp2 = 0.008], and rotations [F = 1.307 P = 0.258, ηp2 = 0.024]). Regarding CPM, intergroup interaction differences were found postintervention (P = 0.002) with a high effect size (d = 0.98).

Conclusions: This study suggests that neural tension technique enhances immediate conditioned pain modulation in patients with chronic neck pain, but not pain intensity or cervical range of movement.

Trial registration: ClinicalTrials.gov NCT02816060.

Keywords: Chronic Neck Pain; Conditioned Pain Modulation; Neural Mobilization.