Among subjects with nonspecific lumbopelvic pain, muscle energy technique was found to decrease worst-reported pain 24 hours after the hands-on intervention, according to a pilot study.

The study, “Short-Term Effect of Muscle Energy Technique on Pain in Individuals with Non-Specific Lumbopelvic Pain: A Pilot Study,” involved 20 subjects with self-reported lumbopelvic pain (LPP).

Participants consisted of 16 males and four females, all about the age of 24, with LPP of moderate severity. According to researchers, these subjects did not feel their pain was severe enough to consult a doctor, and they hoped it would go away on its own.

To be eligible for the study, subjects were required to report an acute episode of LPP within the previous six weeks and show an anterior innominate rotation, as defined by a bilateral difference of two degrees or greater.

Outcome measures for this study included current pain, worst pain over the past 24 hours, which pain provocation test caused the most pain and pain produced during provocation testing. These factors were evaluated before, immediately after and again 24 hours after the hands-on intervention.

Researchers randomly assigned the 20 subjects to receive either muscle energy technique (MET) or a sham hands-on intervention.

Participants in the MET group were supine on a treatment table, with their buttocks just off the edge and the leg of the anterior innominate rotation placed on the practitioner’s shoulder.

During the MET session, each subject was asked to push his or her leg into the practitioner’s shoulder and push up with the opposite leg into the practitioner’s hand; this occurred a total of four times. These contractions were met by the practitioner with a force equal to the force of the subject and held for five seconds, with five seconds of rest in between.

Subjects in the control group also were supine on a treatment table. However, this session consisted of the practitioner placing hands over the anterior superior iliac spine on both sides and maintaining this position for 30 seconds, with no pressure exerted.

The main finding of the study was a decrease in worst pain 24 hours after the hands-on intervention, as reported on a visual analog scale, among subjects in the MET group, with an increase in the same measurement among subjects in the control group.

However, all 20 subjects showed decreased current pain and decreased worst pain provocation test 24 hours after the intervention.

“We hypothesize that … manual contact with the patient may have resulted in alleviation of pain, through the neurophysiological mechanisms of applied movement,” state the study’s authors. “The decrease in pain across both groups could be associated with this effect of clinical touch on pain.”

Authors: Noelle M. Selkow, Terry L. Grindstaff, Kevin M. Cross, Kelli Pugh, Jay Hertel and Susan Saliba.

Source: University of Virginia, Charlottesville. Originally published in Journal of Manual & Manipulative Therapy, 17 (1): 14-18.

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