Neck pain is a common musculoskeletal issue that has been seen as high in terms of disability. Muscle Energy Techniques (MET) are advanced soft tissue techniques to treat Mechanical Neck Pain (MNP). This study compares the Autogenic inhibition (AI) technique with the Reciprocal Inhibition (RI) technique providing conventional treatment to improve functional outcomes. A randomized control trial was conducted at Sindh Institute of Physical Medicine & Rehabilitation, Karachi, Pakistan from August 28, 2021, to December 31, 2021 among 20–50 years old patients with Moderate intensity MNP for more than 4 weeks and with limited Neck ROMs. The sample were divided randomly and allocated into two groups (groups 1 and 2). Group 1 and 2 received 12 sessions of AI and RI with Conventional therapy respectively. The randomization sheet was generated online from randomization.com for a sample size of 80 and two groups of study ‘AI’ and ‘RI’ with a ratio of 1:1 by an independent statistician. Pain (primary outcome), range of motion, and functional disability (secondary outcomes) were assessed through visual analog scale (VAS), Goniometer, and Neck disability index (NDI) at baseline, 1st, and last session respectively. Mean and standard deviation, frequency, and percentages were calculated. Chi-square test and independent t-test compare baseline characteristics. The Repeated Measure Two-Way ANOVA compared mean VAS, NDI, and ROM. The significant P-value was less than 0.05. The mean duration of neck pain was 8 weeks. There was a more significant (p < 0.001) improvement in pain (ES = 0.975), disability (ES = 0.887), neck ROMs; flexion (ES = 0.975), extension (ES = 0.965), right and left lateral flexion (ES = 0.949 and 0.951), and right and left rotation (ES = 0.966 and 0.975) in the AI group than the RI group at 12th session. The Autogenic Inhibition-MET is more beneficial than Reciprocal Inhibition-MET in improving Pain, Range of Motion, and Functional Disability in patients with Sub-Acute and Chronic Mechanical Neck Pain. Therefore, it is a beneficial technique to add with conventional neck pain therapy to get better treatment outcomes in MNP patients. Prospectively registered on ClincalTrials.Gov with ID: NCT05044078.

Background and Objectives: It has been seen that jaw opening is associated with neck extension and jaw closing is associated with neck flexion. This natural association between the jaw and neck can be used as a novel approach to treat chronic non-specific neck pain, although the effects of this concept have never been previously evaluated as a treatment strategy. This article intends to study the effects of integrating jaw opening and closing movements along with active neck exercises versus active neck exercises alone in the management of chronic non-specific neck pain. Materials and Methods: A total of 80 patients, aged 20 to 50, with chronic non-specific neck pain were included in a double-blind randomized controlled trial, conducted at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan from 2018 to 2022. The patients were divided into two groups: Group A patients were assigned jaw movements with active neck exercises, while Group B patients were assigned only active neck exercises. Both groups were assigned isometric strengthening exercises and self-resisted strengthening exercises for cervical spine muscles as a home plan. The study used various outcome measures, including the numerical pain rating scale (NPRS), neck disability index (NDI), neck flexion endurance (NFE), neck extension endurance (NEE), the neck proprioception error (NPE): neck flexion proprioception error (NFPE), neck extension proprioception error (NEPE), neck right rotation proprioception error (NRRPE), and neck left rotation proprioception error (NLRPE), with measurements taken at week 1 and week 6, respectively; the mean differences between the groups were measured using a two-way repeated ANOVA. Results: The experimental group showed better improvements compared to the control group, NPRS (73%), NDI (57%), NFE (152%), NEE (83%), NFPE (58%), NEPE (65%), NRRPE (65%), and NLRPE (62%), with a significant difference (p < 0.05). Conclusions: Active neck extension and flexion movements combined with jaw opening and closing are more effective in reducing pain and disability, improving neck muscles endurance and normalizing neck proprioception in patients with chronic neck pain.

Background: The low back pain (LBP) is a common musculoskeletal condition. There is limited evidence comparing muscle energy technique (MET) versus myofascial mobilization in managing sub-acute Non-specific low back pain (NSLBP). The study’s aim is to evaluate the effectiveness of MET and myofascial mobilization in reducing pain intensity and functional outcomes in NSLBP. Methodology: A clinical trial was performed at Sindh Institute of Physical Medicine and Rehabilitation on 60 participants. Outcome measures used were visual analogue scale (VAS) and Roland Morris Disability Questionnaire (RMDQ) to determine pain and disability respectively at baseline and at post-intervention. Subjects were randomized into experimental and control groups which received MET and myofascial mobilization respectively. However, both groups received standard therapy of transcutaneous electrical nerve stimulation (TENS) and general muscle strengthening exercises. SPSS version 23 was used for analysis of data. Wilcoxon signed ranked test employed to comparison of baseline and after treatment outcomes within the group. The Mann-Whitney test was employed for between-group differences. A p-value below 0.05 was considered as significant. Results: The mean age was 40.9± 8.9 in group A and 44.9±9.3 in group B. 17 (28.3%) were females, and 43 (71.7%) were males. Intra-group analysis revealed statistically significant decrease in pain-like symptoms and level of disability in each group (p < 0.01). However, inter group analysis showed pain and disability were statistically insignificant (p-value > 0.05). Conclusion: It is concluded that MET and myofascial mobilization are equally beneficial for LBP in alleviating pain intensity and disability. Keywords: Disability, Exercise, Muscle Energy Technique, Muscle pain, Myofascial Mobilization, Manual Therapy. Clinical Trial Registration: Prospective registration was done at the clinicaltrial.gov (NCT05428280).