Comparison of Suboccipital Release and Muscle Energy Technique in Subjects With Mechanical Neck Pain and Forward Head Posture

NCT07868497 | Not Yet Recruiting DMC

• 1 other identifier: 866/RC/KEMU
• Study Type: interventional
• Target: 76
• Locations: 1 country
• Sites: 1

Brief Summary

This study will compare two physiotherapy treatments for adults with long-lasting neck pain and tender muscle spots, called trigger points, in the upper trapezius muscle between the neck and shoulder. The aim is to find out which treatment was more effective in reducing pain, improving neck movement, and reducing difficulty with daily activities. The study will includ 76 adults aged 20-40 years at Mayo Hospital, Lahore, Pakistan. Participants will be assigned by chance to one of two treatment groups. One group will receive a cooling spray followed by gentle stretching of the affected muscle. The other group will receive sustained pressure applied by a therapist to the tender muscle spots. Both groups also will receive routine physiotherapy, including heat, exercises, and advice about neck care and posture. Participants will receive six treatment sessions over two weeks. Pain, neck movement, and difficulty with daily activities will be assessed before treatment, immediately after the first session, and after the sixth session.

Conditions

Myofascial Trigger Points; Neck Pain

Keywords

Chronic Neck Pain; Upper Trapezius; Spray and Stretch Technique; Sustained Pressure Technique; Ischemic Compression; Cervical Range of Motion; Neck Disability; Physiotherapy

Outcome Measures

Primary Outcomes (3)

• Pain intensity

  Pain Intensity Measured Using the Visual Analogue Scale

  Baseline, immediately after the first treatment session, and after the sixth treatment session (2 weeks).

• Cervical range of motion

  Active cervical range of motion will be measured in degrees using a goniometer. Measurements included flexion, extension, right and left lateral flexion, and right and left rotation. Higher values indicate greater range of motion.

  Baseline, immediately after the first treatment session, and after the sixth treatment session (2 weeks).

• Neck Related Disability Measured Using the Neck Disability Index

  The Neck Disability Index assesses the effect of neck pain on daily activities through 10 items, each scored from 0 to 5. The total raw score ranges from 0 to 50, with higher scores indicating greater disability.

  Baseline, immediately after the first treatment session, and after the sixth treatment session (2 weeks)

Study Arms (2)

Spray-and-Stretch Plus Conventional Physiotherapy

EXPERIMENTAL

Participants received spray-and-stretch treatment targeting upper trapezius trigger points, alongside conventional physiotherapy. A vapocoolant spray will be applied over the affected muscle, followed by stretching. Conventional physiotherapy will include a hot pack, neck isometric and movement exercises, shoulder shrugs, retraction exercises, and neck-care and posture advice. Treatment will consist of six sessions, three times weekly for two weeks.

Other: Spray and Stretch Technique; Other: Conventional Physiotherapy

Sustained Pressure Plus Conventional Physiotherapy

ACTIVE COMPARATOR

Participants will receive sustained pressure applied by a therapist to upper trapezius trigger points, alongside conventional physiotherapy. Conventional physiotherapy will include a hot pack, neck isometric and movement exercises, shoulder shrugs, retraction exercises, and neck-care and posture advice. Treatment will consist of six sessions, three times weekly for two weeks.

Other: Sustained Pressure Technique; Other: Conventional Physiotherapy

Interventions

Spray and Stretch Technique OTHER

With the participant seated comfortably, a vapocoolant spray will be applied in 3-5 parallel sweeps over the upper trapezius muscle, followed by stretching of the affected muscle. The procedure will be repeated 2-3 times per session. Participants will receive six sessions, three times weekly for two weeks, alongside conventional physiotherapy.

Spray-and-Stretch Plus Conventional Physiotherapy

Sustained Pressure Technique OTHER

The therapist will apply sustained manual pressure to upper trapezius trigger points, adjusting the pressure according to the participant's tolerance. Pressure application will be repeated during each session. Participants will receive six sessions, three times weekly for two weeks, alongside conventional physiotherapy.

Also known as: Sustained Compression, Ischemic Compression

Sustained Pressure Plus Conventional Physiotherapy

Conventional Physiotherapy OTHER

Both groups will receive a hot pack over the upper trapezius for 10 minutes, cervical isometric exercises, active neck movement exercises, shoulder shrugs, retraction exercises, and advice on posture and neck care. Exercises will be progressed during the second week. Conventional physiotherapy will provide during six sessions, three times weekly for two weeks.

Spray-and-Stretch Plus Conventional Physiotherapy; Sustained Pressure Plus Conventional Physiotherapy

Eligibility Criteria

• Age: 20 Years - 30 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Chronic mechanical neck pain lasting at least three months.
• At least one upper trapezius trigger point with painful restriction of cervical range of motion.
• Forward head posture.
• Pain intensity below 7 on the 0-10 Visual Analogue Scale. -

You may not qualify if:

• Previous cervical spine surgery.
• Thoracic outlet syndrome.
• Cervical radiculopathy.
• Skin infection or open wounds in the cervical region.
• Cervical tumour.
• Cervical spine fracture.
• Use of steroid therapy.

Sponsors & Collaborators

• King Edward Medical University: lead

Study Sites (1)

Mayo Hospital, Lahore

Lahore, 54000, Pakistan

Location

MeSH Terms

Conditions

Neck Pain

Interventions

Acupressure

Condition Hierarchy (Ancestors)

Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Therapy, Soft Tissue; Musculoskeletal Manipulations; Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation

Study Officials

• Amna Zia, PhD. Scholar

  King Edward Medical University, Lahore

  PRINCIPAL INVESTIGATOR

• Annusha Arshad

  King Edward Medical University, Lahore

  PRINCIPAL INVESTIGATOR

Central Study Contacts

amna zia, PhD. Scholar

CONTACT

+92 324 4686993; amna.zia@kemu.edu.pk

Annusha Arshad, DPT

CONTACT

+92 300 2677050

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants and outcome assessor will be unaware of the treatment allocation. The treating therapist will be aware of the assigned intervention.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr. Amna Zia, PT

Model Details: Participants will be randomly allocated by lottery to two parallel groups, with 38 participants in each group. One group will receive spray-and-stretch plus conventional physiotherapy, while the other will receive sustained pressure plus conventional physiotherapy. Both groups will receive six sessions over two weeks.

Study Record Dates

• First Submitted: October 5, 2026
• First Posted: October 9, 2026
• Study Start: October 10, 2026
• Primary Completion (Estimated): December 15, 2026
• Study Completion (Estimated): December 30, 2026
• Last Updated: October 9, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)