Clinical Research Directory

CERVICAL EPIDURAL BLOCK IN CHRONIC NECK PAIN

Chronic neck pain can negatively affect daily activities, work ability, and quality of life. Cervical epidural block is commonly used to reduce pain and inflammation, while exercise and physical therapy aim to improve muscle strength, endurance, movement control, and physical function. However, there is limited evidence comparing cervical epidural block alone with its combined use with exercise or physical therapy. This study aims to compare the effects of three treatment approaches in patients with chronic neck pain associated with cervical disc pathology or degenerative changes. Participants will receive cervical epidural block alone, cervical epidural block combined with cervical stabilization exercises, or cervical epidural block combined with physical therapy. Pain intensity, neck-related disability, and quality of life will be evaluated before treatment and at 1, 3, and 6 months after treatment using the Numeric Rating Scale, Neck Disability Index, and 12-Item Short Form Health Survey. The study will determine whether adding exercise or physical therapy to cervical epidural block provides additional clinical and functional benefits.

Accessory Inspiratory Muscles in Chronic Neck Pain

This cross-sectional case-control study aims to investigate the ultrasonographic structural and functional characteristics of accessory inspiratory muscles in individuals with chronic non-specific neck pain and compare them with healthy controls. In addition, the relationships between accessory inspiratory muscle characteristics, diaphragm function, respiratory muscle strength, and pulmonary function parameters will be examined. The findings may improve understanding of the respiratory involvement associated with chronic neck pain and contribute to more comprehensive assessment strategies.

Electroacupuncture on Neck Muscle Stiffness in Chronic Neck Pain

This randomized, single-blind, placebo-controlled clinical trial aims to investigate the immediate physiological effects of a single session of electroacupuncture (EA) on neck muscle stiffness in individuals with chronic neck pain. While acupuncture is a widely used complementary therapy for musculoskeletal pain, high-quality, objective evidence demonstrating its immediate effects on muscle biomechanics remains limited. This study will utilize Shear Wave Elastography (SWE)-a non-invasive, objective ultrasound-based technology-to measure these changes. Adult participants aged 18 to 65 with non-specific chronic neck pain (lasting ≥ 3 months) will be randomly allocated into one of two groups: 1. True Electroacupuncture (EA) Group: Participants will receive a 20-minute session of active electroacupuncture with comfortable electrical stimulation at specific neck and tender points. 2. Sham Acupuncture (Placebo) Group: Participants will receive a 20-minute session of non-penetrating sham acupuncture with a deactivated electroacupuncture device to ensure participant blinding. The primary objective is to evaluate immediate changes in the stiffness of the upper trapezius muscle, measured objectively via SWE (as Young's Modulus in kPa) before and immediately after the intervention. Secondary objectives include assessing immediate post-treatment changes in subjective pain and stiffness (Visual Analogue Scale), Pressure Pain Threshold (PPT), and active Cervical Range of Motion (CROM), alongside a 7-day post-intervention follow-up questionnaire on neck function.

Physical Profile of Cervicogenic Headache: Comparison With Neck Pain and Healthy Controls

The goal of this observational study is to compare physical findings across three adult groups. Cervicogenic headache (CGH) is a headache linked to a problem in the neck. Neck pain may affect posture, muscle function, grip strength, and sensitivity to pressure. Researchers do not know whether CGH has a distinct pattern of these findings. The main questions are: * Do posture, grip strength, muscle stiffness, elasticity, and pressure sensitivity differ among the groups? * Are any differences more closely associated with CGH than with neck pain? Researchers will compare adults ages 25 through 60. One group will include people with CGH lasting at least three months. Another group will include people with neck pain lasting at least six months. People in the neck pain group will have no headaches. Healthy participants will have no neck pain or headaches. Researchers will not provide treatment or change participants' usual care. Each participant will complete one study visit lasting about 15 minutes. Participants will: * Answer short questions about their health and pain * Stand while researchers measure their head and neck posture * Squeeze a device that measures grip strength * Complete brief tests of neck muscle stiffness and elasticity * Tell researchers when applied pressure first becomes painful Researchers will compare results across the three groups. The findings may guide future CGH assessment and treatment research.

Effectiveness of Mulligan Mobilization on Chronic Neck Pain and Range of Motion

This randomized controlled trial was conducted to evaluate the effectiveness of adding Mulligan Mobilization with Movement (MWM) to conventional physiotherapy in patients with chronic mechanical neck pain. Seventy-six participants aged 18-65 years were randomly assigned to receive either conventional physiotherapy alone or conventional physiotherapy combined with MWM for four weeks. Pain intensity, cervical range of motion, and functional disability were assessed before and after the intervention. The study aimed to compare changes in pain intensity, cervical range of motion, and functional disability between the two treatment groups.

Diaphragmatic Myofascial Release Added to Neck Exercises for Chronic Neck Pain

Chronic neck pain can affect daily activities and may be associated with pain, disability, fear of movement, and fatigue. Exercise is commonly used to manage chronic neck pain, but some people continue to experience symptoms despite exercise treatment. This study will investigate whether adding diaphragmatic myofascial release, a hands-on manual therapy directed toward the diaphragm and surrounding tissues, to a neck exercise program provides greater benefits than neck exercises alone in adults with chronic neck pain. Sixty adults aged 25 to 60 years with chronic neck pain lasting more than three months will be randomly assigned to one of two groups. The control group will receive a supervised neck exercise program, while the intervention group will receive the same neck exercise program combined with diaphragmatic myofascial release and related diaphragmatic manual therapy. Both groups will receive treatment for six weeks, with three supervised sessions per week. Pain, neck-related disability, fear of movement, and fatigue will be assessed before treatment, immediately after the six-week intervention, and four weeks after completion of treatment. The study will examine whether adding diaphragmatic myofascial release to neck exercises leads to greater improvements in these outcomes compared with neck exercises alone.

Virtual Pain Education for Spinal Cord Stimulation Patients

Chronic pain is a leading cause of disability in the United States. When standard treatments fail, many patients develop treatment resistant pain and undergo Spinal Cord Stimulation (SCS) therapy. SCS uses an implanted device to send mild electrical currents to the spine to block pain signals before they reach the brain. However, long-term success is often limited by how a patient's nervous system and brain process chronic pain, as well as psychological factors like anxiety and excessive worrying about pain, also known as catastrophizing. To improve outcomes, this study combines SCS therapy with Pain Neuroscience Education (PNE). PNE is an educational approach that teaches patients how the brain and nervous system handle pain signals, reframing pain as a process that can be changed rather than just ongoing tissue damage. The goal of this pilot trial is to test the feasibility of using virtual, remote PNE sessions to help patients reduce pain catastrophizing and anxiety, while building overall psychological resilience. Additionally, the study explores an innovative, objective way to monitor pain levels by analyzing short voice recordings. Researchers want to see if specific vocal features change when a person's pain is well-controlled versus when it is uncontrolled. Participants enrolled in this study will receive either 1) standard spinal cord stimulation or 2) spinal cord stimulation plus the intervention--a virtual, multi-session PNE delivered remotely over a secure telehealth platform. Throughout the study, participants will complete standard clinical surveys to measure their physical function, anxiety, pain catastrophizing, and emotional resilience using standardized tools. Participants will also provide short voice recordings, such as holding a sustained "/ah/" vowel sound, during their virtual assessments. This allows researchers to safely evaluate the direct relationship between subtle voice patterns and reported clinical pain levels.

Muscle Energy Technique Versus Myofascial Release in Chronic Non Specific Neck Pain

Chronic non-specific neck pain is a common musculoskeletal condition that can significantly affect daily activities, sleep quality, and overall quality of life. It is often associated with muscle tightness, poor posture, and reduced neck mobility without any specific underlying structural pathology such as fracture or nerve compression. This study aims to compare two commonly used physiotherapy treatment techniques: Muscle Energy Technique (MET) and Myofascial Release Therapy (MFR) in individuals with chronic non-specific neck pain. A total of 52 participants aged 18-45 years with neck pain lasting more than three months will be included in this randomized controlled trial. Participants will be randomly assigned to one of two groups: Group A: Conventional physiotherapy plus Muscle Energy Technique Group B: Conventional physiotherapy plus Myofascial Release Therapy Both groups will receive treatment twice weekly for four weeks . Conventional physiotherapy will include moist heat application and stretching exercises for neck muscles. In addition, one group will receive Muscle Energy Technique targeting the upper trapezius, levator scapulae, and scalene muscles, while the other group will receive Myofascial Release Therapy targeting the same muscle groups. Outcome measures will be assessed at baseline, at the second week, and at the fourth week. The study will evaluate: Pain intensity (Numeric Pain Rating Scale) Neck range of motion (Inclinometer) Sleep quality (Pittsburgh Sleep Quality Index) Neck-related disability (Neck Disability Index) The results of this study may help determine which technique is more effective in reducing pain, improving movement, enhancing sleep quality, and reducing disability in individuals with chronic non-specific neck pain. This may support clinicians in selecting the most appropriate treatment approach.

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

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.

Diaphragmatic Breathing and Electroacupuncture for Chronic Neck Pain

Chronic non specific neck pain is a prevalent musculoskeletal disorder with significant impact on pain, forward head posture, and neck disability. Diaphragmatic breathing has been shown to improve relaxation and reduce musculoskeletal pain, while electroacupuncture has potential benefits in modulating pain pathways. However, the combined effect of these interventions in chronic neck pain remains unexplored. This randomized clinical trial aims to evaluate the effectiveness of diaphragmatic breathing and electroacupuncture, in addition to physiotherapy care, compared to simple, focused breathing, electroacupuncture, and physiotherapy care. The primary outcomes are the numeric pain rating scale (NPRS) and neck disability index (NDI), while secondary outcome include craniovertebral angle (CVA).

Tech-Assisted Exercise Training in Chronic Neck Pain

In this study, women with chronic neck pain residing in Afyonkarahisar, Turkey, will participate in an exercise-based intervention. Both the control and experimental groups will engage in conventional exercise programs; however, the experimental group will also receive an additional technology-assisted exercise program. It is anticipated that these interventions will positively impact participants' daily living activities and functional abilities. The study aims to assess whether the inclusion of technology-supported exercises leads to superior outcomes compared to conventional exercises alone. The findings are expected to provide valuable evidence on the effectiveness of integrating technology-assisted exercise programs into physiotherapy and rehabilitation practices for women with chronic neck pain.

Acute Effects of Motor Imagery and Motor Control Exercises in Individuals With Chronic Neck Pain

The aim of this study is to compare the effects of single-session motor imagery and motor control exercises on pain, pressure pain threshold, cervical proprioception, and motor imagery in individuals with chronic neck pain.

Effect of Mechanical Traction in Patients With Chronic Neck Pain

This study will be conducted to investigate the effect of mechanical traction on pain, disability, cervical range of motion, sleep quality and insomnia in patients with chronic neck pain. Forty four female patients with chronic neck pain will participate in this study. The patients will be diagnosed as having chronic neck pain based on careful clinical examination by neurologist. Patients in this study will be randomly divided into two equal groups: Group (A): Patients in this group will receive mechanical traction for 20 minutes in addition to conventional physical therapy. Group (B): Patients in this group will receive conventional physical therapy only. The treatment will be conducted over six weeks, three days per week.

Longitudinal Stripping Massage vs. Percussion Device for Neck Pain: Ultrasound Study.

This study evaluates whether a single session of percussion therapy can reduce muscle tension and increase blood flow in the transverse cervical artery in individuals with neck pain. The investigators will evaluate muscle stiffness using ultrasound elastography, and assess blood flow in the transverse cervical artery via Doppler imaging before and after treatment. The primary objective is to determine how this therapy affects neck muscle relaxation and vascular responses, specifically within the upper trapezius region.

Cervical Medial Branch Block Versus Ipsilateral Cervical Erector Spinae Plane Block

This prospective randomized controlled study aims to compare the analgesic effectiveness of ultrasound-guided cervical medial branch block and ipsilateral cervical erector spinae plane block in patients with cervical facetogenic pain. Patients with chronic cervical facet-mediated pain will be randomized into two intervention groups. Pain intensity, functional status, meaningful pain response rates, analgesic consumption, and patient satisfaction will be evaluated during follow-up. The primary objective is to determine whether cervical erector spinae plane block provides comparable short-term pain relief to cervical medial branch block.

Effects of Neck Stabilizers Retraining on Chronic Neck Pain

The present study aims to evaluate the effects of deep neck stabilizers retraining with pressure biofeedback on cervical range of motion, pain, and temporomandibular dysfunction in patients with chronic neck pain. Participants will receive biofeedback-assisted deep neck flexor retraining in one group, while the other group will perform conventional exercises. The neurological connection between the TMJ and neck means that therapies such as neck flexion exercises and biofeedback can alleviate neck pain and jaw issues.

Kinesiophobia, Pain and Disability in Chronic Neck Pain

This study aims to investigate the mediating role of kinesiophobia in the relationship between pain intensity and disability in individuals with chronic neck pain. Chronic neck pain is a multidimensional clinical condition influenced not only by biological factors but also by psychological components such as fear of movement. Understanding the mechanisms underlying disability may contribute to more targeted rehabilitation strategies. Participants with chronic neck pain lasting at least three months will be assessed using validated self-report questionnaires measuring pain intensity, kinesiophobia, disability, and physical activity levels.

Chronic Low Back Pain and Neck Pain Prospective Study

This prospective observation multifaceted study aims: 1. To perform a large prospective study and identify multiple "omics" biomarkers in chronic low back pain 2. To validate identified biomarkers for progression of acute to chronic low back pain 3. To validate identified biomarkers and test their heritability/validity in additional cohorts 4. To identify pathways and relevant individual variations for generation, propagation and subsidence of pain 5. To identify new imaging biomarkers related to chronic low back pain 6. To develop a registry of neck and low back pain subjects to help monitor the health-care management and utility to improve protocols and patient outcomes.

Respiratory Exercises Versus Deep Neck Flexor Training in Chronic Mechanical Neck Pain

This study will be conducted to compare the effect of adding respiratory exercises versus deep neck flexor training to conventional program on pain, cervical ROM, cervical muscle endurance, function, and chest expansion in patients with chronic mechanical neck pain. Sixty-six (66) of both genders ranging in age from 18 to 35 years old, with a history of mechanical neck pain longer than 3 months (chronic neck pain) will be invited to participate in this study. Participants will be randomly assigned into one of the three experimental groups as follow: Group A will receive respiratory exercises in form of diaphragmatic breathing \& respiratory muscle stretch gymnastics plus conventional program. Group B will receive deep neck flexor training in the form of low-load craniocervical flexion using feedback from an air-filled pressure sensor placed behind the neck plus conventional program. Group C (control group) will receive conventional program in form of TENS, infrared, isometric neck strengthening exercises and stretching exercises.

Chronic Neck Pain and Kinesiophobia

In this study, the primary aim was to examine the relationship between kinesiophobia and clinical outcomes in individuals with chronic neck pain. The secondary aim was to compare the level of neck disability, pain, endurance, functionality, muscle and grip strength, and quality of life in individuals with chronic neck pain who had and did not have kinesiophobia; and to determine the determinants of kinesiophobia in patients with chronic neck pain.

The Effectiveness of the Polyvagal Theory in Chronic Neck Pain

This study aimed to examine the effectiveness of a polyvagal theory-based exercise approach on joint position sense, pain, range of motion, functionality, depression, and quality of life in individuals with chronic neck pain. H0 = The polyvagal theory-based exercise approach has no significant effect on joint position sense, neck pain, range of motion, functionality, depression, or quality of life. H1 = The polyvagal theory-based exercise approach has a significant effect on joint position sense, neck pain, range of motion, functionality, depression, and quality of life.

Masseter Muscle Thickness in Individuals With Chronic Neck Pain

The primary objective of our study is to compare the thickness of the masseter muscle, measured by ultrasound, in individuals with chronic neck pain to that of healthy individuals. The secondary objective of the study is to examine the relationships between masseter muscle thickness and pain intensity, neck disability level, pain catastrophizing level, and clinical diagnostic criteria in individuals with chronic neck pain.

Symmetrical Scapula-pelvis Proprioceptive Neuromuscular Facilitation and Superficial Back Line in Chronic Neck Pain With Hamstring Tightness

A research study will be conducted at Physiotherapy department of the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan. Overall 156 patients with 18-40 years old individuals with neck pain will be eligible and they will be included through non-probability, purposive sampling technique. The written informed consent will be taken from all the patients. They will be divided through Simple random sampling (computer generated software) method into two groups, 78 in each group. Group A (experimental group) will receive PNF Symmetrical Scapula-Pelvis Patterns (PNF-SSPP), group B (control group) will receive sub occipital muscle inhibition technique (SMI) and static stretching (SS) of hamstring muscle. All participants will be assessed using assessment form. Outcome measures will be Pain, disability, disability, neck range of motions, hamstring tightness, head posture, and levator scapulae index. An independent assessor blinded to the treatment will assess all the patients for treatment outcome assessment at baseline, after first session and post treatment. Treatment sessions will be given thrice a week for 6 weeks.

Effects of Different Exercise Protocols on Physical and Cognitive Changes in People With Chronic Neck Pain

This study aims to investigate the effects of different exercise approaches on physical status, cognitive functions, brain structures, and blood biomarkers in individuals with chronic neck pain.