This study will be conducted to compare between Mulligan mobilization technique and Active release technique in management of non-specific chronic neck pain as regard to neck pain, cervical range of motion and neck function.
Inclusion Criteria
Have referred from orthopedic surgeon diagnosed with NSCNP that has been localized to the cervical and periscapular areas for at least three months
Aged from 18-40 years
Having a score more than 10 on the Neck disability index (NDI)
History of previous neck surgery.
Recent or old fractures.
Cognitive impairment and inability to understand the scale.
Systematic inflammatory disease e.g., rheumatoid arthritis and ankylosing spondylitis, neck pain with radiculopathy or neuropathy.
Parallel
Conventional treatment
Other interventiontwelve participants will receive only the conventional physical therapy program prescribed for chronic non-specific neck pain in the form of: 1.Source of superficial heat using hot packs for 15 minutes. 2.Postural correction exercises. 3.Isometric strengthening exercises for neck muscles in all directions (Flexion, extension, side bending and rotation). 4.Stretching for common tight muscles (Trapezius, levator scapulae and sternocleidomastoid muscles). 5.Chin tuck exercises. 6.Scapular stabilization exercises
mulligan mobilization
Other interventionParticipant will sit comfortably supported in a chair with a neutral head and cervical spine position. Practitioner, A gentle, painless posterior-to-anterior (PA) glide will be applied to the facets (bony projections) on the spinous process or the articular pillar/cervical lamina. This glide will be maintained throughout the movement. Participant Action: While the glide will be held, the participant actively will move their neck in the direction that previously caused pain. If pain-free, the participant can gently push further into the movement restriction
active release technique
Other interventionThe patient will sit on a stool with hands supported on the thighs, the therapist will apply deep pressure on both sides of levator scapulae and upper trapezius muscles (over the area of tenderness) and the patient will be instructed to actively move the muscle from a shortened to lengthened position and thereby breaking adhesions.1 set of 3-5 repetitions in one session
Cervical range of motion
Cervical ROM will be assessed using CROM device.
Neck function
Arabic version of neck disability index will be used to assess neck function
Pain intensity
Numerical Rating Scale will be used to assess pain intensity
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