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What is Counterstrain?

By Sandra Koehler
Updated: May 17, 2024

Counterstrain is a technique used in osteopathic medicine that helps treat physical problems called somatic dysfunction. Somatic dysfunction refers to situations where the body is unable to function correctly. This method of hands-on therapy can address pain and decreases the amount of movement of a body part especially in the muscles, joints, nerves or lymphatic system.

The form of osteopathic manipulative therapy called counterstrain is dependent on finding the tender point. This is the body position where pain is at its highest. Once the highest pain is achieved the procedure of counterstrain calls for loosening of the position until the pain is no longer felt. This posture is held for several minutes until a release or relaxation of the area is felt. Then the body is moved back to full resting or neutral position.

When the body experiences the point of highest pain, the involved area becomes tight. This hypertonicity or area of too much muscle tension is the result of an abnormal reflexive muscular contraction. This means the body feels pain and spasms or tightens up to avoid additional discomfort. This reaction then can create a pain cycle, protecting the area even when pain issues begin to resolve.

When the body demonstrates this protective response to pain, many bodily functions can become impaired. Blood vessels, for example, can tighten, slowing blood flow. This can also lead to sluggish waste removal. Nerves may become trapped or constricted from the increased muscle pressure. This can cause pain issues to radiate or spread out from the involved area. Nerves may also continually send pain messages throughout the body, thus resulting in the reflexive pain cycle.

By maintaining the body in a painless position but not in complete rest, counterstrain allows the body to become comfortable with a new alignment. Holding the new position allows the body to relax and call off the pain signals causing muscle spasms. This can increase the overall range of motion of the area involved. It can also coax the body out of the reflexive pain cycle.

The treatment of somatic dysfunction through counterstrain may require several sessions for the body to recognize the new pattern of decreased pain. Once the sequence of pain and tightness has been halted, the internal body functions, such as lymph drainage, organ activity and blood flow can resume normally. Issues of nerve impingement may also lessen due to the relaxation of the musculature surrounding them.

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