Neck Pain Chronic

The study aims to assess the efficacy and safety of acupuncture among patients with chronic nonspecific neck pain and insomnia, compared with sham acupuncture.

This Randomized Clinical Trial will be conducted at Riphah Rehabilitation and Research Center and spans 4 weeks. Non-probability Convenient sampling will be used to collect the data. A sample size of 40 subjects with age group between 18-45 years will be taken. Data will be collected from patients who use electronic gadgets and have present complaints of mechanical neck pain. Outcome measures will be taken using the Numeric pain rating scale (NPRS) for pain, Neck Disability Index (NDI) for disability, Goniometer for Range of motion, and Kinovea software for shoulder, eye, and craniovertebral angle measurement. Subjects will be selected based on inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. The first assessment will be conducted physically and after that, both groups will receive treatment via MS teams under the supervision of a physiotherapist. Both the Groups will receive Hot Pack, and baseline treatment (neck isometrics, upper trapezius and scalene stretches), while Group A will receive multimodal exercises (chin tucks, bilateral pectoral stretching, scapular region strengthening exercises, and Wand exercises) and Group B will receive Bruegger's relief exercise. Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 25.

This study aims to investigate the effectiveness of low-load endurance exercise as compared to stretching exercise on upper trapezius on pain, pressure pain and muscle stiffness in patients with chronic neck-shoulder pain. The hypothesis is that endurance exercise of the upper trapezius should result in significantly better improvement in terms of neck-shoulder pain, pressure pain threshold and muscle stiffness than stretching exercise. Participants with unilateral neck-shoulder pain will either perform low-load endurance exercise or stretching exercise of the upper trapezius muscle of the affected side in a 5-week period. Before and after the 5-week training, outcomes will be assessed by investigators in order to compare the effectiveness of two exercises on pain, pressure pain, muscle stiffness, and muscle endurance. Secondary outcomes include Neck Disability Index (NDI) to assess various aspects of daily living impacted by neck pain, and Disabilities of Shoulder, Arm and Hand (DASH) Questionnaire to evaluate the ability to perform various upper limb activities. Findings to be obtained from this study will help inform the clinical management in particular for self-care of this chronic neck pain group of participants, by refining the exercise prescription for promoting the clinical outcomes for individuals suffering from neck-shoulder pain. In addition, results of this study will also inform physiotherapists the possible mechanisms underlying the improvement of neck-shoulder pain by examination of the relationship between biomechanical properties of muscles, such as muscle endurance or muscle stiffness, and neck-shoulder pain.