Comparative Effects of Myofascial Decompression and Positional Release Therapies in Chronic Non-specific Neck Pain
Condition: Chronic Non-specific Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      Nonspecific neck pain is defined as a neck pain not attributable to an identifiable, known
      specific pathology. The frequency of neck pain as found to be 84% which is exceptionally high
      and these are the majority of the individuals with neck pain that present to physiotherapy.
      In many cases, various factors contribute to the development of non-specific neck pain. These
      might include physical strain at work, such as working on something above you or sitting at a
      desk without moving enough. Emotional stress, like worries and anxiety about family or work,
      often plays an important role. It is thought that in some cases the cause may be an
      over-stretch (sprain) of a ligament or muscle. In other cases the cause may be a minor
      problem with a disc between two spinal bones (vertebrae), or a minor problem with a small
      facet joint between two vertebrae. Objective of this study will be to compare the effects of
      myofascial decompression and positional release therapies on pain, range of motion and
      functional disability in chronic nonspecific neck pain.
    

Detailed description: 
      Neck pain is one of the most common and painful musculoskeletal conditions. Point prevalence
      ranges from 6% to 22% and up to 38% of the elderly population, while lifetime prevalence
      ranges from 2% to 71%. For the majority of the neck disorders there is an absence of an
      identifiable underlying disease or abnormal anatomical structure. From this perspective
      .NS-NP is mainly 'diagnosed' on the basis of clinical grounds, provided there are no features
      to suggest a specific or more serious condition. The symptoms of nonspecific neck pain are
      similar to those of whiplash associated disorders (WAD) grade I and II but there is no
      traumatic event involved. Nonspecific neck pain (NP) is defined as pain in the posterior and
      lateral aspect of the neck between the superior nuchal line and the spinous process of the
      first thoracic vertebra with no signs or symptoms of major structural pathology and no or
      minor to major interference with activities of daily life as well as with the absence of
      neurological signs and specific pathologies. Chronic nonspecific neck pain is diagnosed as
      cervical pain without a known pathological basis as the underlying cause of the complaints.
      Some symptoms are limited cervical spine mobility and neck muscles weakness, which may be
      often related to other problems, such as, vertebral, neck or shoulder impaired function, and
      mental and physical stress at work. The natural course of non-specific neck pain remains
      unclear. While it is often self-limiting within a few weeks of onset, it can severely limit
      daily functioning, induce substantial medical consumption and result in prolonged sick leave
      and disability leading chronic nonspecific neck pain if pain duration is more than three
      months. As a consequence, it places a heavy burden on individuals, employers and health care
      services. Nonspecific neck pain is defined in the European guidelines for the management of
      chronic nonspecific neck pain that is not attributable to a recognizable, specific pathology
      (e.g., infection, tumor, osteoporosis, fracture, structural deformity, and inflammatory
      diseases, such as ankylosing spondylitis, radicular syndrome. Characteristic of chronic
      nonspecific neck pain are heavy pain, worsening with exertion and relieve with rest. In some
      cases the cause may be sprain or overstretch of a ligament or muscles. Nonspecific neck
      belongs to the group of musculoskeletal disorders, which include diverse conditions affecting
      muscles, bones, and/or joints of the limbs or the spine. As for most other musculoskeletal
      disorders, nonspecific neck is multifactorial. A variety of different types of exercise have
      been explored to treat chronic neck pain, including low-to-moderate intensity aerobic
      exercise, high intensity aerobic exercise, stretching exercise and muscular strength
      exercises and isometrics. However, the most effective form of exercise as a method of
      rehabilitation non-specific neck pain is unknown reflecting its complexity and more research
      is require. The rationale of the study is to compare the effects of myofascial decompression
      and positional release therapies on pain, range of motion and functional disability in
      chronic nonspecific neck pain. The main purpose of myofascial decompression therapy and
      positional release therapy is to release the cervical trigger points, improving end ranges
      and lengthening of muscle. MDT helps draw toxins out of the muscles and to the superficial
      veins to be removed by the body. This leads to decreased pain and tension in the tissues. The
      ultimate goal is to achieve pain free end ranges and flexibility of muscle in nonspecific
      neck pain patients.
    

Intervention name(s): Myofascial Decompression Therapy; positional Release Therapy
Intervention type(s): Other; Other
Intervention description(s): Group A will be given myofascial decompression therapy.15 minute's moist heat will be given first. Patient was lied prone on couch with their upper torso unclothed, covered with massage oil than placed cup on skin and suction will created by pump. Than drawn over skin along the spine from cervical to thoracic up to lateral border maintain the suction within skin throughout the procedure. The cup massage will conducted for approximately 10 minutes. Patients were informed that the treatment area may become patchy and there are chances of ecchymosis on the same area.; Group B will be given Positional Release technique (PRT) after application of moist heat pack for 15 minute. The subjects received PRT will be in supine lying with the therapist sitting on the affected side, tender points were located along with the upper fibers of trapezius muscle. The subject's head was laterally flexed towards the side of tender point, then therapist grasps the subject's forearm and abducts shoulder to approximately 90 degree and adds slight flexion or extension to fine-tune. The ideal position of comfort achieved was held for a period of 90 sec and followed by passive return of body part to an anatomically neutral position continued for 5 minutes. Treatment duration was 3 sessions per week for 4 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: non-specific neck pain; myofascial decompression therapy; positional release therapy