Effect of Adding Stretching Techniques to Standardized Intervention on Nonspecific Mechanical Neck Pain

Abstract

Mechanical neck pain is becoming one of the leading causes of musculoskeletal disorders in the general adult population. Mobilization intervention is considered one of the most effective therapeutic techniques to treat non-specific neck pain. The purpose of this study was to investigate the benefit of adding stretching exercises as part of a rehabilitation program for patients with non-specific mechanical neck pain. Methods: Thirty-eight subjects with non-specific neck pain for at least 2 weeks with mean± SD age 30.9±8.1 years and body mass index (BMI) 26.8±6.7 kg/m2 participated in the study. Participants were randomly assigned to either the combined intervention (passive cervical mobilization and stretching techniques) (n1=18) or standard intervention group (n2=20). The outcome measures were Cervical range of motion (CROM), Numeric Pain Rating scale, Neck Disability Index, Global Rating of Change (GROC), and pressure pain threshold. Results: There was a significant difference in mean CROM during extension over time (p=0.002, η2=0.20), and a significant group by time interaction (p=0.02). The percent improvement from baseline to 4 weeks later was significant between the combined intervention and standard intervention groups (18.9% vs. 3.0%; p=0.02). Also, there was a significant difference in mean CROM during right lateral flexion over time (p\u3c0.001, η2=0.30), and a significant group by time interaction (p=0.04). The percent improvement from baseline to 4 weeks was significant between the combined intervention and standard intervention groups (23.2% vs. 10.8%; p=0.04). However, subjective outcome measures including pain, patient’s satisfaction and neck disability index significantly improved overtime with no significant differences between the two study groups. Over time, there was a significant difference in mean right upper trapezius muscle pain threshold (p=0.02), and for GROC (p\u3c0.001, η2=0.54), however, there was no significant group by time interaction, and the improvement over time did not differ by study group (p\u3e0.05). Conclusions: Four weeks of combined techniques (cervical mobilization plus stretching exercises) showed to be more effective than standard intervention in terms of improving cervical extension and lateral flexion CROM