Effects of SNAGs & CBT on Pain, Craniovertebral Angle & Disability in Non Specific Neck Pain

Summary

Non-specific neck pain is a prevalent condition causing discomfort, reduced craniovertebral angle, and disability. This randomized controlled trial will evaluate the combined effects of Sustained Natural Apophyseal Glides (SNAGs) and Cognitive Behavioral Therapy (CBT) on pain, posture, and function. Group A will receive SNAGs and CBT, while Group B will undergo SNAGs with cervical stabilization exercises, twice weekly for four weeks. Outcomes will include pain, craniovertebral angle, and disability, analyzed using SPSS.

Conditions

• Neck Pain
• Cognitive Behavior Therapy
• Cervicalgia
• Posture
• Posterior Neck Pain
• Neck Pain and Forward Head Posture

Interventions

OTHER

Cognitive behavior therapy

The treatment session will begin with a 10-minute conventional therapy, including a 5-minute hot pack applied to the cervical region and a 5-minute Myofascial Release (MFR) using skin rolling and cross-hand techniques to relax and stretch the fascia layers. This will be followed by a 10-minute application of Sustained Natural Apophyseal Glides (SNAGs), where the physiotherapist will guide the patient's active neck movements with accessory glides to improve joint ROM and reduce pain. Lastly, a 20-minute Cognitive Behavioral Therapy (CBT) session will include visual aids, explanations of cervical spine biomechanics, pain pathways, ergonomics, and posture management. Patients will receive manuals summarizing key points and be encouraged to engage actively. The 40-minute session will be conducted twice weekly for four weeks

OTHER

Cervical Stabilization Exercises

The treatment session will last 40 minutes, twice a week for 4 weeks. It begins with a 10-minute conventional treatment: a 5-minute hot pack application to the cervical region followed by a 5-minute Myofascial Release (MFR) using the skin rolling technique. Natural wax will be applied for smooth strokes. MFR will engage all fascia layers with superficial strokes, progressing to deeper fascia using cross-hand stretch, depending on the pain tolerance. Next, SNAGs (Sustained Natural Apophyseal Glides) will be applied for 10 minutes. The patient, seated, will actively move the painful joint through its range of motion while the therapist applies a glide force. This will be repeated 10 times for 3 sets. Then session includes 20 minutes of Cervical Stabilization Exercises (CSE) with bracing in neurodevelopment stages (supine, prone, quadrupedal, bipedal), holding each position for 10 seconds. Isometric exercises and functional training with elastic bands and exercise balls follow.

Sponsors & Collaborators

• Riphah International University

  lead OTHER

Principal Investigators

• Hira Shaukat, TDPT · Riphah International University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

28 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-06-10

Primary Completion

2025-10-01

Completion

2025-12-10

Countries

• Pakistan

Study Locations