Health Trials

Effects of Different Myofascial Release Techniques on Function in Chronic Non-Specific Neck Pain

ConditionsChronic Neck PainNon-specific Neck PainMyofascial Trigger PointsMyofascial Pain Syndrome - Neck
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-45
SponsorEastern Mediterranean University

About this trial

This single-center, three-arm randomized controlled trial compares the effects of different myofascial release techniques, combined with a structured exercise program, on functional outcomes in individuals with chronic non-specific neck pain (CNNP).

Eligible participants (aged 18 to 45 years, neck pain for at least 3 months, pain intensity VAS at least 3, and myofascial trigger points in the upper-quarter muscles) are allocated by simple randomization into three groups:

* Conventional Therapy Group: hot pack, conventional TENS, and a structured exercise program. * Manual Myofascial Release Group: conventional therapy plus therapist-applied manual myofascial release. * Self-Myofascial Release Group: conventional therapy plus supervised self-applied myofascial release using a duo-ball, balls, and a massage stick/cane.

All interventions are delivered 3 days per week for 6 weeks. The primary outcome is pain intensity. Secondary outcomes include pressure pain threshold and tolerance, cervical range of motion, muscle stiffness, craniovertebral angle, cervical proprioception, muscle strength and endurance, disability, neck awareness, multidimensional biopsychosocial status, sleep quality, quality of life, and kinesiophobia. The aim is to determine whether manual or self-applied myofascial release, added to exercise, produces greater functional improvement in people with chronic non-specific neck pain.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Neck pain persisting for at least 3 months and diagnosed as chronic non-specific neck pain by a specialist physician

Aged between 18 and 45 years

Perceived pain affecting daily living activities (VAS at least 3)

Presence of myofascial trigger points in the upper-quarter muscles

Disqualifiers

Specific serious cervical spine pathology (radiculopathy, myelopathy, severe nerve root compression, spondylosis, and similar)

History of rheumatologic, neurologic, or systemic disease (for example, acute inflammation, multiple sclerosis, Parkinson's disease, rheumatoid arthritis, fibromyalgia, or cancer)

History of trauma, fracture, or surgery involving the neck, shoulder, or upper extremity

Pregnancy or breastfeeding

Trial design

Design model

Parallel

Treatments tested in this trial

  • Hot Pack

    Other intervention

    Hot pack applied to the cervical region.

  • Conventional TENS

    Device

    Conventional transcutaneous electrical nerve stimulation applied to the most painful region: 80 Hz frequency, 100 microsecond pulse duration, asymmetric biphasic rectangular waveform, set to a tingling sensation, for 20 minutes.

  • Structured Exercise Program

    Behavioral

    Structured standard exercise program including warm-up, stretching of cervical and shoulder-girdle muscles, diaphragmatic breathing, motor control (chin tuck and craniocervical flexion), scapular stabilization, strengthening of the middle and lower trapezius, and cool-down.

  • Manual Myofascial Release

    Procedure/Surgery

    Therapist-applied manual myofascial release, including trigger point ischemic compression and along-fiber release to the suboccipital, upper trapezius, levator scapulae, sternocleidomastoid, rhomboid, infraspinatus, and pectoral muscles, with sustained compression of approximately 90 seconds combined with passive movements.

  • Self-Myofascial Release

    Behavioral

    Supervised self-applied myofascial release using a duo-ball, massage balls, and a massage stick/cane, targeting the same upper-quarter muscle groups, with sustained compression of approximately 90 seconds combined with active movements.

Treatment groups

84 Participants
are divided into 3 treatment groups
Group A: Conventional Therapy GroupActive comparator 3 interventions
Group B: Manual Myofascial Release GroupExperimental treatment 4 interventions
Group C: Self-Myofascial Release GroupExperimental treatment 4 interventions

Trial outcomes

Primary outcomes

1

Change in Pain Intensity (Visual Analog Scale, VAS)

Pain intensity measured on a 10 cm Visual Analog Scale (0 = no pain, 10 = worst imaginable pain), assessed at rest, during activity, and at night.

Time frame
Baseline, immediately after the first session, and after the final session (end of week 6)

Secondary outcomes

1

Pressure Pain Threshold and Tolerance

Pressure pain threshold and tolerance of the upper-quarter muscles measured with a Wagner Instruments FDIX digital pressure algometer (1 cm2 rubber tip); the mean of three repetitions per point is recorded.

Time frame
Baseline, immediately after the first session, and after the final session (end of week 6)
2

Cervical Range of Motion

Cervical range of motion in flexion, extension, lateral flexion, and rotation measured with a Meloq AB digital goniometer, in degrees; the best of three active repetitions is recorded.

Time frame
Baseline, immediately after the first session, and after the final session (end of week 6)
3

Muscle Stiffness

Myofascial tissue stiffness measured with the IndentoPro digital indentometer, expressed in N/mm; the mean of three repetitions per muscle is recorded.

Time frame
Baseline, immediately after the first session, and after the final session (end of week 6)
4

Craniovertebral Angle

Craniovertebral angle (forward head posture) assessed by photogrammetry from a right sagittal photograph and analyzed with one software, in degrees; smaller angles indicate more pronounced forward head posture.

Time frame
Baseline and after the final session (end of week 6)

Other outcomes

Sponsors and contacts

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Eastern Mediterranean University

Lead sponsor

Source ClinicalTrials.gov
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