Comparison of Active Release Technique and Post Isometric Relaxation Technique on Pain and Functional Disability in Patient With Mechanical Neck Pain

Neck pain is one of the leading causes of musculoskeletal pain and disability in the world. Despite the prevalence, accompanying disabilities, low quality of life and economic burdens of mechanical neck pain, there is a gap in high quality evidence to effectively guide the conservative treatment of this patient population. Active release technique (ART) is a soft tissue technique that focuses on removal of adhesions that build up in muscle due to overuse. ART can be used as both, as a diagnostic and treatment technique.

Limited literature is available on evaluation and treatment of neck pain by Active release technique in contrast to Post isometric release technique. This study fulfills this gap and will provide clinicians with an alternative treatment approach for mechanical neck pain.

Neck pain is defined by the Global Burden of health 2010 Study as "pain in the neck with or without pain referred into one or both upper limbs that lasts for at least one day" and is one of the leading causes of musculoskeletal pain and disability in the world. Neck pain can be classified into radicular neck pain and axial neck pain. Radicular pain radiates along the nerves and is caused by irritated nerves, whereas axial pain, also called as mechanical pain, is confined to one spot or region.

Despite the prevalence, accompanying disabilities, low quality of life and economic burdens of mechanical neck pain, there is a gap in high quality evidence to effectively guide the conservative treatment of this patient population. Physical therapy management of patients with neck pain mostly include the use of treatment approaches consisting of both manual therapies including cervical spine manipulation and/or mobilization and exercise programs training for treatment of symptoms of mechanical neck pain. Active release technique (ART) is a soft tissue technique that focuses on removal of adhesions that build up in muscle due to overuse. ART can be used as both, as a diagnostic and treatment technique. Post isometric relaxation technique (PIR) is a muscle energy technique that is mostly used to relax and lengthen stiff and shortened muscles. PIR uses the muscles own energy in form of isometric contractions to relax the muscle via autogenic inhibition.

A Bacon et al (2011) conducted a study on effects of ART on tension headaches and reported that ART improved the symptoms associated with tension headaches and showed good results. A study by S Joshi et al (2018) compared the effectiveness of ART and conventional physical therapy for management of upper cross syndrome and concluded that Active release technique with conventional therapy is more effective than conventional therapy alone in the management of upper cross syndrome. Similarly, S Tak et al (2013) investigated on the effects of ART on gluteus medius for chronic pain in lower back pain and concluded that ART was effective in reducing the pain symptoms in lower back.

Limited literature is available on evaluation and treatment of neck pain by Active release technique in contrast to Post isometric release technique. This study fulfills this gap and will provide clinicians with an alternative treatment approach for mechanical neck pain.

Eligibility Criteria:
Inclusion Criteria

* Patients with diagnosed mechanical neck pain
* Having NDI score of equal to or more than 10%
* Patients having neck pain less than 8 on NPRS

Exclusion Criteria:

* Patients having non-musculoskeletal injury
* Patients with nerve root compression
* Whiplash injuries
* History of cervical or thoracic spine surgery
* Patient on pain medication for neck pain