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

Summary

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.

Conditions

• Chronic Neck Pain
• Non-specific Neck Pain
• Myofascial Trigger Points
• Myofascial Pain Syndrome - Neck

Interventions

OTHER

Hot Pack

Hot pack applied to the cervical region.

DEVICE

Conventional TENS

Conventional transcutaneous electrical nerve stimulation applied to the most painful region: 80 Hz frequency, 100 microsecond pulse duration, asymmetric biphasic rectangular waveform, set to a tingling sensation, for 20 minutes.

BEHAVIORAL

Structured Exercise Program

Structured standard exercise program including warm-up, stretching of cervical and shoulder-girdle muscles, diaphragmatic breathing, motor control (chin tuck and craniocervical flexion), scapular stabilization, strengthening of the middle and lower trapezius, and cool-down.

PROCEDURE

Manual Myofascial Release

Therapist-applied manual myofascial release, including trigger point ischemic compression and along-fiber release to the suboccipital, upper trapezius, levator scapulae, sternocleidomastoid, rhomboid, infraspinatus, and pectoral muscles, with sustained compression of approximately 90 seconds combined with passive movements.

BEHAVIORAL

Self-Myofascial Release

Supervised self-applied myofascial release using a duo-ball, massage balls, and a massage stick/cane, targeting the same upper-quarter muscle groups, with sustained compression of approximately 90 seconds combined with active movements.

Sponsors & Collaborators

• Eastern Mediterranean University

  lead OTHER

Principal Investigators

• Süleyman Güzelşemme · Eastern Mediterranean University

• Sevim Öksüz, PT, Assoc. Prof. Dr. · Eastern Mediterranean University

• Ender Angın, PT, Prof. Dr. · Eastern Mediterranean University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

45 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-07-14

Primary Completion

2026-09-06

Completion

2026-12-31

Countries

• Cyprus

Study Locations