The strain - Counter strain technique in the management of anterior interosseous nerve syndrome: A case report

Anterior interosseous nerve syndrome (AINS) is a proximal median nerve neuropathy affecting the forearm. Trigger points in the anterior compartment of the forearm may cause compression of the anterior interosseous nerve (AIN) which, in turn, may result in muscle weakness. Here we present the case of a 37-year-old female who complained of an abnormal pen grip while writing. Clinical examination (observation, palpation, pincer grip strength) showed weak pincer grip strength, an active trigger point in the middle of the anterior forearm and a positive circle sign. Her treatment course included cryomassage, neural mobilization, transcutaneous electrical nerve stimulation (TENS) and the strain-counter strain (SCS) technique four times a week for two weeks. On follow-up, the patient reported an inactive trigger point on palpation, improvement in her handwriting and improved pincer (fingertip pinch) grip strength in pounds (lbs) as recorded by the Baseline Hydraulic Pinch Gauge. This case report explored the effectiveness of SCS as an important adjunct to other conservative treatments for entrapment neuropathies. SCS has also shown its potential to improve muscle strength.