The goal of this clinical trial is to determine the effect of Muscle Energy Techniques on post dural puncture headache, neck pain and disability after Cesarean Section.

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Caesarean section (CS) is the worldwide process of pregnancy termination that delivers live or dead fetuses with an incision on the abdominal wall and uterine wall.

It is performed under neuraxial anesthesia (spinal and epidural anesthesia). Post- dural puncture headache (PDPH) is a major complication of neuraxial anesthesia which presents as a dull throbbing pain in a frontal-occipital distribution, aggravates on sitting or standing, and is reduced by lying down.

This study will be a randomized clinical trial. Subjects with PPDH meeting the predetermined inclusion and exclusion criteria will be divided into two groups: i.e. treatment and control group. Both groups will receive baseline treatments i.e. (heating pads & TENS). In addition, treatment group will receive post-isometric relaxation of METs. Each subject will receive a total of 4 treatment sessions, with 2 treatment sessions per day

Pre-treatment will be done at day 1 and post-treatment will be done at day 2, using Headache Disability Index (HDI), Numeric Pain Rating Scale (NPRS) and Neck Disability Index (NDI) as subjective measurements. Recorded values will be analysed for any change using SPSs

Inclusion Criteria:

• Age between 18 to 40 years
• Both Primiparous and multiparous
• Both elective and emergency Lower Section Cesarean Section
• Headache occurring within 24-72 hours post C-section
• Headache aggravates on getting in upright position

Exclusion Criteria:

• History of Trauma/fracture of head and neck region
• History of cervical spine surgery
• Had previous diagnostic Lumbar Puncture (LP)
• Any kind of infection, malignancy, inflammation and structural deformity present in head and neck region.
• Other serious forms of headaches including Migraine, Cluster, thunderclap, hypnic etc.
• Cervical Radiculopathies and spondylolisthesis