Sacroiliac Joint DysfunctionSCS-MAITLAND-SNCT07645170
Strain Counter-Strain vs Maitland Mobilization for Sacroiliac Joint Pain
A study testing Strain Counter-Strain Technique and Maitland Mobilization in people with Sacroiliac Joint Dysfunction, run by University of Faisalabad at 1 site in Pakistan.
Trial summary
This randomized clinical trial compares two manual therapy techniques for treating sacroiliac joint dysfunction, a condition that causes lower back and buttock pain. The two techniques are strain counter-strain, an indirect positional release method, and Maitland mobilization grades II and III, a direct joint… Read more about this study
- Who is it for?
- Ages 20 to 40 years
- Conditions the study is for
- Sacroiliac Joint Dysfunction
- What is being tested?
- Strain Counter-Strain Technique and Maitland Mobilization
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 34 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Feb 2026to 15 Aug 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age 20 to 40 years, including both males and females
- Pain at the level of the sacroiliac joint region below L5 and radiating to the buttocks or back of thigh
- Pain duration of 8 weeks or longer
- Baseline pain intensity of 3 or greater on the Numeric Pain Rating Scale
- Modified Oswestry Disability Index score of at least 30 percent
- At least 3 positive provocation tests out of 5: Gaenslen test, distraction test, compression test, thigh thrust test, and sacral thrust test
- Willing and able to provide written informed consent
Who cannot join
- Age below 19 years or above 40 years
- Recent lumbar or hip surgery within the past 6 months
- Lumbar or pelvic fracture
- Infectious conditions including bone tumors, nerve root irritation, and tuberculosis of the spine or hip
- Pre-diagnosed inflammatory joint diseases including rheumatoid arthritis and ankylosing spondylitis
- Any condition that contraindicates manual therapy
- Pregnancy (if applicable - you may want to add this, as SIJ pain is common in pregnancy but manual therapy protocols may differ)
- Unable or unwilling to provide informed consent
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
The University of Faisalabad
Faisalābad, Punjab Province, 3800
About this study
Official title: Comparative Effects of Strain Counter-Strain Versus Maitland Mobilization Technique (Grade II and III) for Reducing Pain and Functional Limitation in Patients With Sacroiliac Joint Dysfunction
This randomized clinical trial compares two manual therapy techniques for treating sacroiliac joint dysfunction, a condition that causes lower back and buttock pain. The two techniques are strain counter-strain, an indirect positional release method, and Maitland mobilization grades II and III, a direct joint oscillation technique. Thirty-four participants aged 20 to 40 years with confirmed sacroiliac joint dysfunction will be randomly assigned to receive either strain counter-strain or Maitland mobilization three times per week for four weeks. Both groups will also receive a 10-minute moist hot pack before each treatment. Pain will be measured using the Numeric Pain Rating Scale and functional limitation using the Modified Oswestry Disability Index at baseline and after four weeks. The study aims to determine which technique is more effective for reducing pain and improving function in this patient population.
Read the detailed description
This is a double-blind, parallel-group, randomized clinical trial to be conducted at three hospitals in Faisalabad, Pakistan: National Hospital Faisalabad, Health 360 Faisalabad, and Madinah Teaching Hospital Faisalabad. The study duration is six months following synopsis approval. A total of 34 participants will be enrolled using simple random sampling. Inclusion criteria include: age 20 to 40 years, both males and females, pain at the sacroiliac joint region below L5 radiating to buttocks or back of thigh for at least 8 weeks, baseline pain intensity of 3 or more on the Numeric Pain Rating Scale, Modified Oswestry Disability Index score of at least 30 percent, and at least three positive provocation tests out of five (Gaenslen test, distraction test, compression test, thigh thrust test, and sacral thrust test). Exclusion criteria include: recent lumbar or hip surgery, lumbar or pelvic fracture, infectious conditions such as bone tumors or tuberculosis, inflammatory joint diseases such as rheumatoid arthritis or ankylosing spondylitis, and refusal to provide informed consent. Participants will be randomly assigned to two groups of 17 each. Group A will receive strain counter-strain technique targeting the quadratus lumborum, piriformis, and erector spinae muscles. The therapist will position the patient comfortably for 90 seconds per muscle, repeated three times per muscle, for three sets per session. Group B will receive Maitland mobilization grades II and III applied to the sacrum. Grade II will be used in week one and early week two for pain reduction, using 3 to 4 sets of 30-second oscillations. Grade III will be introduced by the end of week two and used primarily in weeks three and four for 40-second sets to improve mobility. Both groups will receive a 10-minute moist hot pack to the gluteal area before each treatment. Treatments will be delivered three times per week for four weeks. Outcome measures will be assessed at baseline and after completion of the fourth week. The Numeric Pain Rating Scale is an 11-point scale from 0 (no pain) to 10 (worst possible pain). The Modified Oswestry Disability Index contains ten sections each scored 0 to 5, converted to a percentage where higher scores indicate greater disability. Data will be analyzed using SPSS version 20. Between-group comparisons will be conducted using independent t-tests for normally distributed data or Mann-Whitney U tests for non-normal data. Within-group comparisons will use paired t-tests or Wilcoxon signed-rank tests. Statistical significance will be set at p less than 0.05.
- Conditions
- Sacroiliac Joint Dysfunction
- Being tested
- Strain Counter-Strain Technique, Maitland Mobilization
- Keywords
- Sacroiliac joint, manual therapy, strain counter-strain, Maitland mobilization, physical therapy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Strain Counter-Strain TechniqueProcedure or surgery
Strain counter-strain is an indirect manual therapy technique based on the proprioceptive hypothesis of somatic dysfunction. The therapist identifies tender points in the quadratus lumborum, piriformis, and erector spinae muscles. The patient is then placed in a comfortable position that reduces tension in the targeted muscle. This position is maintained for 90 seconds, after which the therapist passively returns the patient to the starting position. The procedure is repeated three times per muscle, with three sets per session. Treatment is provided three times per week for four weeks. A 10-minute moist hot pack is applied to the gluteal area before the technique begins.
Maitland MobilizationProcedure or surgery
Maitland mobilization is a manual therapy technique using passive oscillatory motions to treat joint pain and stiffness. The patient is positioned in prone lying. The therapist places hands centrally on the upper sacrum and applies pressure in a postero-anterior direction. Grade II (large amplitude, low intensity) is used for pain reduction in week one and early week two, with 3 to 4 sets of 30-second oscillations at 2 to 3 Hz. Grade III (large amplitude, high intensity) is introduced by the end of week two to improve stiffness and function, using 40-second sets at 2 to 3 Hz through weeks three and four. One Grade II session is added in week four to maintain pain relief. Treatment is provided three times per week for four weeks. A 10-minute moist hot pack is applied to the gluteal area before mobilization begins.
| Study group | Role | What they receive |
|---|---|---|
| Strain Counter-Strain Group | Experimental | Participants in this arm receive strain counter-strain technique applied to the quadratus lumborum, piriformis, and erector spinae muscles. The therapist places the patient in a comfortable position for each corresponding muscle for 90 seconds, repeated three times per muscle, for three sets per session. Treatment is delivered three times per week for four weeks. Each session begins with a 10-minute moist hot pack to the gluteal area. Receives: Procedure: Strain Counter-Strain Technique |
| Maitland Mobilization Group | Active comparator | Participants in this arm receive Maitland mobilization grades II and III applied to the sacrum in prone lying. Grade II is used in week one and early week two using 3 to 4 sets of 30-second oscillations. Grade III is introduced by the end of week two and used primarily in weeks three and four for 40-second sets to improve mobility. Treatment is delivered three times per week for four weeks. Each session begins with a 10-minute moist hot pack to the gluteal area. Receives: Procedure: Maitland Mobilization |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Pain Intensity
Pain intensity is measured using the Numeric Pain Rating Scale (NPRS), an 11-point scale from 0 (no pain) to 10 (worst possible pain). Participants rate their current pain level at the sacroiliac joint region. The scale is administered by a blinded outcome assessor.
Measured: Baseline and after 4 weeks of treatment (week 4)
Secondary outcomes (1)
Change in Functional Limitation
Functional limitation is measured using the Modified Oswestry Disability Index (MODI) questionnaire. The MODI contains ten sections covering activities of daily living: pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, traveling, and employment/homemaking. Each section is scored from 0 to 5, with total score converted to a percentage. Higher percentages indicate greater disability. Scores are classified as: minimal disability (0 to 20 percent), moderate disability (21 to 40 percent), severe disability (41 to 60 percent), crippled (61 to 80 percent), and bed-bound or exaggerated symptoms (81 to 100 percent). The questionnaire is administered by a blinded outcome assessor.
Measured: Baseline and after 4 weeks of treatment (week 4)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jun 2026
- Study start1 Feb 2026
- Primary completion24 Jul 2026
- Study completion15 Aug 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Sacroiliac Joint DysfunctionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 34 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Faisalabad
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Dr Waqar Younas, University of Faisalabad
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07645170
- Sponsor's protocol ID
- TUF/EIRB/ 208 /26
- Acronym
- SCS-MAITLAND-S
- Status last verified
- Jun 2026
- First submitted
- 8 Jun 2026
- Last updated
- 19 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 19 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Strain Counter-Strain Versus Maitland Mobilization Technique (Grade II and III) for Reducing Pain and Functional Limitation in Patients With Sacroiliac Joint Dysfunction
- ClinicalTrials.gov ID
- NCT07645170
- Acronym / sponsor ID
- SCS-MAITLAND-S / TUF/EIRB/ 208 /26
- Conditions
- Sacroiliac Joint Dysfunction
- Keywords
- Sacroiliac joint, manual therapy, strain counter-strain, Maitland mobilization, physical therapy
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 34 participants (actual)
- Lead sponsor
- University of FaisalabadUniversity, hospital or other
- Study start
- 1 Feb 2026 (actual)
- Primary completion
- 24 Jul 2026 (actual)
- Study completion
- 15 Aug 2026 (estimated)
- First posted
- 12 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This randomized clinical trial compares two manual therapy techniques for treating sacroiliac joint dysfunction, a condition that causes lower back and buttock pain. The two techniques are strain counter-strain, an indirect positional release method, and Maitland mobilization grades II and III, a direct joint oscillation technique. Thirty-four participants aged 20 to 40 years with confirmed sacroiliac joint dysfunction will be randomly assigned to receive either strain counter-strain or Maitland mobilization three times per week for four weeks. Both groups will also receive a 10-minute moist hot pack before each treatment. Pain will be measured using the Numeric Pain Rating Scale and functional limitation using the Modified Oswestry Disability Index at baseline and after four weeks. The study aims to determine which technique is more effective for reducing pain and improving function in this patient population.
Detailed description
This is a double-blind, parallel-group, randomized clinical trial to be conducted at three hospitals in Faisalabad, Pakistan: National Hospital Faisalabad, Health 360 Faisalabad, and Madinah Teaching Hospital Faisalabad. The study duration is six months following synopsis approval. A total of 34 participants will be enrolled using simple random sampling. Inclusion criteria include: age 20 to 40 years, both males and females, pain at the sacroiliac joint region below L5 radiating to buttocks or back of thigh for at least 8 weeks, baseline pain intensity of 3 or more on the Numeric Pain Rating Scale, Modified Oswestry Disability Index score of at least 30 percent, and at least three positive provocation tests out of five (Gaenslen test, distraction test, compression test, thigh thrust test, and sacral thrust test). Exclusion criteria include: recent lumbar or hip surgery, lumbar or pelvic fracture, infectious conditions such as bone tumors or tuberculosis, inflammatory joint diseases such as rheumatoid arthritis or ankylosing spondylitis, and refusal to provide informed consent. Participants will be randomly assigned to two groups of 17 each. Group A will receive strain counter-strain technique targeting the quadratus lumborum, piriformis, and erector spinae muscles. The therapist will position the patient comfortably for 90 seconds per muscle, repeated three times per muscle, for three sets per session. Group B will receive Maitland mobilization grades II and III applied to the sacrum. Grade II will be used in week one and early week two for pain reduction, using 3 to 4 sets of 30-second oscillations. Grade III will be introduced by the end of week two and used primarily in weeks three and four for 40-second sets to improve mobility. Both groups will receive a 10-minute moist hot pack to the gluteal area before each treatment. Treatments will be delivered three times per week for four weeks. Outcome measures will be assessed at baseline and after completion of the fourth week. The Numeric Pain Rating Scale is an 11-point scale from 0 (no pain) to 10 (worst possible pain). The Modified Oswestry Disability Index contains ten sections each scored 0 to 5, converted to a percentage where higher scores indicate greater disability. Data will be analyzed using SPSS version 20. Between-group comparisons will be conducted using independent t-tests for normally distributed data or Mann-Whitney U tests for non-normal data. Within-group comparisons will use paired t-tests or Wilcoxon signed-rank tests. Statistical significance will be set at p less than 0.05.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Strain Counter-Strain Group | Experimental | Procedure: Strain Counter-Strain TechniqueParticipants in this arm receive strain counter-strain technique applied to the quadratus lumborum, piriformis, and erector spinae muscles. The therapist places the patient in a comfortable position for each corresponding muscle for 90 seconds, repeated three times per muscle, for three sets per session. Treatment is delivered three times per week for four weeks. Each session begins with a 10-minute moist hot pack to the gluteal area. |
| Maitland Mobilization Group | Active comparator | Procedure: Maitland MobilizationParticipants in this arm receive Maitland mobilization grades II and III applied to the sacrum in prone lying. Grade II is used in week one and early week two using 3 to 4 sets of 30-second oscillations. Grade III is introduced by the end of week two and used primarily in weeks three and four for 40-second sets to improve mobility. Treatment is delivered three times per week for four weeks. Each session begins with a 10-minute moist hot pack to the gluteal area. |
Who may qualify
- Ages
- 20 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (7 listed)
- Age 20 to 40 years, including both males and females
- Pain at the level of the sacroiliac joint region below L5 and radiating to the buttocks or back of thigh
- Pain duration of 8 weeks or longer
- Baseline pain intensity of 3 or greater on the Numeric Pain Rating Scale
- Modified Oswestry Disability Index score of at least 30 percent
Key exclusion criteria (8 listed)
- Age below 19 years or above 40 years
- Recent lumbar or hip surgery within the past 6 months
- Lumbar or pelvic fracture
- Infectious conditions including bone tumors, nerve root irritation, and tuberculosis of the spine or hip
- Pre-diagnosed inflammatory joint diseases including rheumatoid arthritis and ankylosing spondylitis
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Strain Counter-Strain TechniqueStrain counter-strain is an indirect manual therapy technique based on the proprioceptive hypothesis of somatic dysfunction. The therapist identifies tender points in the quadratus lumborum, piriformis, and erector spinae muscles. The patient is then placed in a comfortable position that reduces tension in the targeted muscle. This position is maintained for 90 seconds, after which the therapist passively returns the patient to the starting position. The procedure is repeated three times per muscle, with three sets per session. Treatment is provided three times per week for four weeks. A 10-minute moist hot pack is applied to the gluteal area before the technique begins. | Procedure or surgery | Strain Counter-Strain Group |
| Maitland MobilizationMaitland mobilization is a manual therapy technique using passive oscillatory motions to treat joint pain and stiffness. The patient is positioned in prone lying. The therapist places hands centrally on the upper sacrum and applies pressure in a postero-anterior direction. Grade II (large amplitude, low intensity) is used for pain reduction in week one and early week two, with 3 to 4 sets of 30-second oscillations at 2 to 3 Hz. Grade III (large amplitude, high intensity) is introduced by the end of week two to improve stiffness and function, using 40-second sets at 2 to 3 Hz through weeks three and four. One Grade II session is added in week four to maintain pain relief. Treatment is provided three times per week for four weeks. A 10-minute moist hot pack is applied to the gluteal area before mobilization begins. | Procedure or surgery | Maitland Mobilization Group |
Primary outcome
Change in Pain Intensity
Time frame: Baseline and after 4 weeks of treatment (week 4)
Pain intensity is measured using the Numeric Pain Rating Scale (NPRS), an 11-point scale from 0 (no pain) to 10 (worst possible pain). Participants rate their current pain level at the sacroiliac joint region. The scale is administered by a blinded outcome assessor.
1 secondary outcome
Change in Functional Limitation
Time frame: Baseline and after 4 weeks of treatment (week 4)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Aug 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Strain Counter-Strain Technique and Maitland Mobilization in people with Sacroiliac Joint Dysfunction, run by University of Faisalabad at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 19 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Pain Intensity (time frame: Baseline and after 4 weeks of treatment (week 4)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Aug 2026.