Effects of the Suboccipital Muscle Inhibition Technique on Pain, Functional Disability and Quality of Life in Patients with Sacroiliac Joint Pain: a Randomized Controlled Trial

Background. Sacroiliac joint pain is a common source of lower back pain, affecting a large number of the global population. However, Muscle Energy Techniques (METs) have been shown to be effective in managing this condition but there has been limited exploration of the potential additional benefits of combining METs as convention­al treatment with other manual therapy techniques (suboccipital muscle Inhibition technique). Methods. This randomized controlled trial was conducted on thirty-eight patients with sacroiliac joint pain. Non-probability convenient sampling technique was used. The data was collected from patients of Sacro-iliac joint pain by using Numerical pain rating scale for pain, Urdu version of Oswestry Disability Index (ODI) for functional disability and Health Questionnaire EQ-5D 5L for quality of life. Patient were equal­ly divided in to two groups by computer generated random number table. Control Group received conventional therapy including Hot pack, transcutaneous electrical nerve stimulator (TENS), therapeutic ultrasound and general METs autogenic inhibi­tion technique for SIJ while Experimental Group received conventional therapy and Suboccipital muscle inhibition technique. Outcomes were measured at base line and then after 2 weeks of treatment (at the last treatment session no treatment was given after it) and to check long term treatment follow up was taken after 6 weeks of the last treatment session. Results. Both groups reported significant improvement in all outcome measures from baseline to follow-up. However, the combination of Sub-occipital Inhibition Tech­nique with conventional treatment as experimental group demonstrated superior benefits, with a decrease of 17.58 points in ODI, 6.74 points in Numeric Pain Rating Scale (NPRS), and an increase of 38.00 in EQ5L scores (all p < 0.001). The control group showed a reduction of 11.26 points in ODI, a decrease of 5.53 points in NPRS, and an increase of 36.42 in EQ5L scores (all p < 0.001). A medium to large effect size was observed for all outcomes. SPSS version 27 was used to analyze the data. Conclusions. Combination of Sub-occipital Inhibition Technique with conventional treatment produced better clinical and statistical improvement in terms of all paraeters, indicating that inclusion of Sub-occipital Inhibition Technique in conventional treatment may provide enhanced therapeutic benefits. Study registration. The trial was prospectively registered in the WHO-Iranian registry of clinical trials (IRCT20190717044238N8, dated: April 03, 2023) (https://www.irct. ir/).