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

NCT07694882 | Recruiting

• 1 other identifier: ETK00-2026-0042
• Study Type: interventional
• Target: 84
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Chronic Neck Pain; Non-specific Neck Pain; Myofascial Trigger Points; Myofascial Pain Syndrome - Neck

Keywords

chronic non-specific neck pain; myofascial release; manual therapy; trigger points; therapeutic exercise; physiotherapy

Outcome Measures

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.

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

Secondary Outcomes (14)

• Pressure Pain Threshold and Tolerance

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

• Cervical Range of Motion

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

• Muscle Stiffness

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

• Craniovertebral Angle

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

• Cervical Proprioception (Joint Position Error)

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

Study Arms (3)

Conventional Therapy Group

ACTIVE COMPARATOR

Hot pack to the cervical region, conventional TENS, and a structured standard exercise program, delivered 3 days per week for 6 weeks.

Other: Hot Pack; Device: Conventional TENS; Behavioral: Structured Exercise Program

Manual Myofascial Release Group

EXPERIMENTAL

Conventional therapy (hot pack, conventional TENS, and structured exercise program) plus therapist-applied manual myofascial release, delivered 3 days per week for 6 weeks.

Other: Hot Pack; Device: Conventional TENS; Behavioral: Structured Exercise Program; Procedure: Manual Myofascial Release

Self-Myofascial Release Group

EXPERIMENTAL

Conventional therapy (hot pack, conventional TENS, and structured exercise program) plus supervised self-applied myofascial release using a duo-ball, balls, and a massage stick/cane, delivered 3 days per week for 6 weeks.

Other: Hot Pack; Device: Conventional TENS; Behavioral: Structured Exercise Program; Behavioral: Self-Myofascial Release

Interventions

Hot Pack OTHER

Hot pack applied to the cervical region.

Conventional Therapy Group; Manual Myofascial Release Group; Self-Myofascial Release Group

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.

Conventional Therapy Group; Manual Myofascial Release Group; Self-Myofascial Release Group

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.

Conventional Therapy Group; Manual Myofascial Release Group; Self-Myofascial Release Group

Manual Myofascial Release PROCEDURE

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.

Manual Myofascial Release Group

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.

Self-Myofascial Release Group

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• 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

You may not qualify if:

• 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
• Any diagnosed psychiatric disorder (for example, major depression or anxiety disorder) or regular use of psychopharmacological medication
• Use of systemic analgesics, NSAIDs, or muscle relaxants within the last 7 days for pain control
• Any physiotherapy, manual therapy, or injection treatment to the neck region within the last 3 months

Sponsors & Collaborators

• Eastern Mediterranean University: lead

Study Sites (1)

Eastern Mediterranean University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Healthy Living Center (SAYMER), Orthopedic Rehabilitation Unit

Famagusta, Hatay, 99628, Cyprus

RECRUITING

Related Publications (3)

• Overmann L, Schleip R, Anheyer D, Michalak J. Effectiveness of myofascial release for adults with chronic neck pain: a meta-analysis. Physiotherapy. 2024 Jun;123:56-68. doi: 10.1016/j.physio.2023.12.002. Epub 2023 Dec 15.

  PMID: 38290198 BACKGROUND

• Fernandez-de-Las-Penas C, Dommerholt J. International Consensus on Diagnostic Criteria and Clinical Considerations of Myofascial Trigger Points: A Delphi Study. Pain Med. 2018 Jan 1;19(1):142-150. doi: 10.1093/pm/pnx207.

  PMID: 29025044 BACKGROUND

• GBD 2021 Neck Pain Collaborators. Global, regional, and national burden of neck pain, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2024 Mar;6(3):e142-e155. doi: 10.1016/S2665-9913(23)00321-1.

  PMID: 38383088 BACKGROUND

Study Officials

• Süleyman Güzelşemme

  Eastern Mediterranean University

  PRINCIPAL INVESTIGATOR

• Sevim Öksüz, PT, Assoc. Prof. Dr.

  Eastern Mediterranean University

  STUDY DIRECTOR

• Ender Angın, PT, Prof. Dr.

  Eastern Mediterranean University

  STUDY DIRECTOR

Central Study Contacts

Süleyman Güzelşemme, PT, PhD(c)

CONTACT

+905397892296; suleyman.guzelsemme@gmail.com

Sevim Öksüz, PT, Assoc. Prof. Dr.

CONTACT

sevim.oksuz@emu.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants are not informed that the study has three groups, are unaware of the group allocation and the content of the other groups, and are enrolled so that they do not know one another.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator PhD (c)

Model Details: Three arm parallel group randomized controlled trial: a Conventional Therapy Group, a Manual Myofascial Release Group, and a Self-Myofascial Release Group.

Study Record Dates

• First Submitted: July 5, 2026
• First Posted: July 10, 2026
• Study Start: July 14, 2026
• Primary Completion (Estimated): September 6, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: July 14, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

CY (1)