Clinical trial NCT05947214: Comparative Effects of Myofascial Decompression and Positional Release Therapies in Chronic Non-specific Neck Pain
Official title: Comparative Effects of Myofascial Decompression and Positional Release Therapies on Pain, Range of Motion and Functional Disability in Chronic Non-specific Neck Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Chronic Non-specific Neck Pain
Keywords: non-specific neck pain
myofascial decompression therapy
positional release therapy
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2023-07-17
Enrollment: 38
Sex: ALL
Minimum age (years): 25
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief 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.

Eligibility criteria: Inclusion Criteria:

1. Neck patients age 25 to 50 years.
2. Both male and female genders.
3. Mild to moderate back pain with NPRS pain score value of between more than 6/10.
4. Pain from at least past three months (12 weeks).
5. Trigger points within the muscle.

Exclusion Criteria:

1. Diagnosis of systemic metabolic and/or neurological disorders.
2. Patients with sensory impairments, such as diabetic sensory neuropathy. Neuropathic pain.
3. Any referred pain or neurological involvement in lower limbs is not included.

Primary outcomes:
measure: Numerical Rating Scale (NPRS)
timeFrame: 6th week
measure: Neck Disability Index (NDI)
timeFrame: 6th week
Secondary outcomes:
measure: ROM cervical spine (flexion)
timeFrame: 6th week
measure: ROM cervical spine (extension)
timeFrame: 6th week
measure: ROM cervical spine (side flexion)
timeFrame: 6th week
measure: . ROM cervical spine (Rotation)
timeFrame: 6th week
Other outcomes:
Locations:
city: Lahore
country: Pakistan
facility: Riphah international university
state: Punjab
Study officials:
affiliation: Riphah International University Lahore Campus
name: Sana Hafeez, PhD*
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Spellman J, Eldredge R, Nelson M, Ostrowski J, Concannon J. Is Myofascial Decompression Effective at Increasing Hamstring Flexibility in the Athletic Population? A Critically Appraised Topic. J Sport Rehabil. 2022 Aug 8;31(8):1100-1104. doi: 10.1123/jsr.2022-0013. Print 2022 Nov 1.
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