Neck Pain

This research aims to evaluate the additional effects of sternocleidomastoid muscle release combined with suboccipital muscle release in managing cervicogenic headache, a condition caused by dysfunction in the C1-C2 vertebrae and marked by neck stiffness and limited neck rotation. Cervicogenic headache significantly impacts daily activities and is associated with forward head posture and weak deep neck muscles. The study is a randomized control trial conducted by Foundation University Islamabad to explore these manual therapy techniques alongside conventional physical therapy treatments. Participants are divided into two groups. Group A will receive suboccipital muscle release consisting of three repetitions of three minutes each (total 9 minutes), combined with conventional physical therapy including TENS and hot pack therapy for 10 minutes, six days a week for two consecutive weeks. Group B will receive sternocleidomastoid muscle release for 5 minutes plus the same suboccipital muscle release and conventional physical therapy schedule as group A. Both interventions are delivered over 12 sessions in total. During the study, participants will undergo assessments to measure pain intensity and range of motion after two weeks of treatment. Researchers will monitor headache symptoms, neck function, and muscle performance using clinical tests like the flexion rotation test. The study does not involve masking or blinding, and all participants will be adults aged 18 to 45 years. The total participation period includes the two-week treatment phase followed by outcome evaluations.

This research aims to evaluate the effects of two different physical therapy techniques, Neuromuscular Reeducation (NMR) and Post Facilitation Stretch (PFS), on Upper Cross Syndrome among IT professionals. The study involves adults aged 20 to 40 years who have been diagnosed with this condition and have experienced pain for at least two months. The goal is to compare these techniques for improving symptoms related to this syndrome. Participants are divided into two groups: one group receives the NMR technique, which involves deep pressure along the muscles from origin to insertion combined with active movement and rest periods. The other group receives the PFS technique, which consists of isometric muscle contractions followed by rapid stretching and relaxation. Both groups also perform strengthening exercises for weak muscles as part of their treatment. The treatments are applied specifically to tight muscles including the levator scapulae, upper trapezius, and pectoralis major. Before treatment, baseline measurements are taken for neck range of motion (ROM), pain intensity using the Numeric Pain Rating Scale (NPRS), and neck disability index. After two weeks of treatment, these measures are repeated to assess changes. Participants undergo assessments at the start and after two weeks to compare improvements. The study monitors neck function, pain levels, and disability related to the syndrome throughout the treatment period.

Researchers are evaluating the analgesic effect and safety of a mixed reality (MR) based cognitive distraction focus relaxation therapy for patients diagnosed with chronic moderate to severe pain. This multicenter, prospective, single-blind, randomized, and parallel controlled trial aims to assess the impact of a digital chronic pain treatment system using MR technology as part of basic clinical care for chronic pain patients. Participants are assigned to one of two groups: the pain key group receiving mixed reality pain treatment software with MR-based pain scenarios, or a control group exposed to the same content displayed on a 2D TV screen. The study compares these approaches to understand the role of MR technology in managing chronic pain. During the study, participants will be monitored using the Visual Analogue Scale (VAS) to measure pain levels over three days. Researchers will collect data on pain intensity and safety outcomes while participants follow the treatment protocols. The trial runs from October 2023 to June 2025, involving adults aged 18 to 85 years with chronic pain lasting more than three months.

Researchers are investigating treatments for temporomandibular disorders (TMD), which are increasingly common and affect jaw function and cause pain. This study aims to evaluate whether combining manual therapy with vagus nerve stimulation, a nerve linked to pain and jaw function, offers better relief and improved quality of life than manual therapy alone. The study involves 20 participants diagnosed with myogenic TMD, focusing on pain, jaw movement, and distress. Participants are randomly assigned to one of two groups: one receiving manual therapy combined with vagus nerve stimulation and the other receiving only manual therapy. Both groups undergo four physiotherapy sessions, one per week over a month, and are trained to continue treatment exercises at home over two months. The manual therapy includes joint manipulation and soft tissue techniques for the jaw. Throughout the study, an independent evaluator will assess participants monthly using questionnaires to measure chronic pain, jaw function, physical symptoms, range of motion, and distress. The main outcomes are changes in health status and chronic pain after two months. This double-blind, randomized study ensures unbiased results by keeping evaluators unaware of group assignments. Participant involvement spans two months of treatment and assessments.

Researchers are conducting a first-in-human, randomized, placebo-controlled study to assess the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of TT5 given at different doses in healthy volunteers and surgical patients. This phase 1 trial includes both single and multiple ascending dose parts and involves healthy and surgical participants aged 18 to 55 years. The study aims to explore TT5's effects, including psychological responses and potential fluid biomarkers. The study consists of three parts: Part A tests single ascending intravenous doses of TT5 in healthy participants across up to five dose levels; Part B evaluates multiple ascending doses over seven days in healthy participants with up to three dose levels; and Part C administers intravenous doses on the same day to surgical patients in up to three dose levels. Both TT5 and placebo (vehicle) are given intravenously, and dosing schedules vary according to the study part. Participants will be monitored for adverse events, vital signs, physical exams, laboratory tests, and psychological responses using tools like the Bond and Lader Visual Analog Scale. Pharmacokinetic measurements will include plasma and urine analysis over specified days. Safety and tolerability will be assessed through day 8 for single doses and day 14 for multiple doses. The total study duration varies by cohort, with close follow-up during and after dosing to evaluate TT5's effects and safety.

Researchers are studying whether the handheld device called Grasp can help reduce pain and distress in children and adolescents aged 8 to 15 during small needle procedures. These procedures include venous puncture, insertion of a peripheral venous catheter, and local anesthesia injections before dental treatment. The study aims to compare the effects of using Grasp during these procedures with standard care to see if it helps improve the experience for young patients. Grasp is a soft silicone ball with pressure sensors that detect squeezes of different strengths and durations. When squeezed, it provides real-time visual and auditory feedback through an iPad application, playing melodies and showing dynamic curves. Participants in the intervention group will squeeze the Grasp ball repeatedly, starting at least 10 seconds before and continuing throughout the needle procedure. The control group will receive standard care without Grasp. In addition to the randomized trial, six children with type 1 diabetes will use Grasp during blood sugar measurements or insulin injections as part of exploratory use. During the study, participants will fill out questionnaires about their pain and distress before and after the procedure, as will their parents or guardians. Some participants at the dental clinic will use Grasp during further dental treatment and complete additional forms afterward. The main measure is self-reported pain immediately after the procedure, with secondary measures including distress reported by both children and parents. The study includes interviews with some participants to explore their experiences, and statistical analyses will assess the impact of using Grasp.

Researchers are evaluating the safety, tolerability, and how the body processes the drug iN1011-N17 after oral administration in healthy volunteers and patients with post-herpetic neuralgia (PHN). This phase 1b study also compares the bioavailability of two salt forms of iN1011-N17 (Mesylate versus Hydrochloride) in healthy volunteers. The study is designed as a randomized, double-blind, placebo-controlled trial with multiple ascending doses to better understand the drug's effects and behavior. The study consists of three parts. In Part 1, participants receive either iN1011-N17 or placebo twice daily for 7 days using different formulations (suspension or capsules). Part 2 involves a crossover design where healthy volunteers receive single doses of each salt form in two separate periods with a washout time of at least 5 days. Part 3 includes two cohorts of healthy volunteers and PHN patients randomized to receive iN1011-N17 or placebo twice daily for 14 days. Throughout, dosing occurs approximately 12 hours apart with the final dose on the morning of the last day. Participants undergo various assessments including monitoring for adverse events, physical exams, vital signs, ECGs, cardiac telemetry, and laboratory tests from baseline through follow-up periods averaging 14 to 22 days depending on the part. Additional tests evaluate drug concentration levels, metabolism, and elimination. The study also tracks pharmacokinetic and pharmacodynamic properties to assess how the drug is absorbed, distributed, metabolized, and cleared. Participants are expected to attend all visits and comply with study requirements during the treatment and monitoring phases.

Researchers are conducting a multi-center clinical longitudinal study to better understand neuropathic pain by examining patients' brain activity and cognitive function. The study collects detailed data on pain levels, sleep quality, social support, anxiety, depression, and cognitive tasks using various scales and imaging techniques. This observational research aims to track changes in these factors during acute pain episodes in adults aged 18 to 85 years. Participants diagnosed with neuropathic pain will join the study and receive standard care from the pain department while being observed over time. The study includes evaluations using pain scales like the Visual Analogue Scale (VAS) and digital pain grading (NRS), as well as assessments of sleep, anxiety, cognitive function, and brain activity through electroencephalogram (EEG) and near-infrared brain imaging (fNIRS). Follow-up continues up to three months after enrollment to monitor changes. During the study, participants will undergo various assessments including pain scoring, cognitive tests, emotional tasks, and questionnaires on sleep and social support. Brain function will be monitored using EEG and fNIRS. Researchers will evaluate measures such as pain intensity, sleep quality, anxiety and depression levels, and cognitive abilities at one month. Participants' progress will be closely observed throughout the study period, which lasts at least three months post-enrollment.

Researchers are evaluating a multicomponent mindfulness and movement program called Move-MORE designed for patients with lumbosacral radiculopathy, a condition causing pain, weakness, and numbness in the lower limbs often known as sciatica. The study aims to develop this non-invasive, non-drug treatment by combining mindfulness training, gentle physical activity, and motivational interviewing to help manage pain and improve function. The study will assess the program's feasibility, acceptability, and preliminary effects on pain, disability, and psychological factors. Participants will engage in the Move-MORE program remotely, attending weekly virtual classes for eight weeks. The program includes mindfulness practice, physical activity, and motivational interviewing based on self-determination theory. Between sessions, participants will track their home practice, pain levels, and any adverse events through daily surveys. The intervention is specifically tailored for those with lumbosacral radiculopathy, using feedback from patients and physicians to guide program design. During the study, participants will complete online surveys at baseline, midpoint, post-intervention, and three-month follow-up, including daily pain ratings via ecological momentary assessment. They will wear an activity monitor continuously to measure movement and undergo quantitative sensory testing to assess pain sensitivity. At the end, participants will share their experiences in interviews to help refine the program. The primary outcome measured is disability related to back pain, with additional assessments of pain characteristics and satisfaction.

Degenerative Cervical Myelopathy (DCM) is an age-related condition mainly affecting people aged 50 and over, caused by changes in the spine like ligament ossification or disc problems that compress the cervical spinal cord. It leads to symptoms such as hand numbness, clumsiness, and difficulty walking. This research aims to develop new surgical criteria based on physical performance tests alongside MRI and clinical signs to better guide surgery decisions for DCM, focusing on the Chinese population. The study involves confirming DCM diagnosis using MRI and orthopedic surgeon evaluation. Researchers will use physical performance tests such as the 10-second Grip and Release test, 10-second Stepping Test, and Foot Tapping Test over 24 months to assess functional deficits. These tests, combined with clinical indicators and MRI findings, will help establish objective criteria to predict the need for surgery. Participants will be evaluated regularly for their physical abilities and neurological function using these performance tests. The study will monitor changes over 24 months to assess hand and gait coordination. Researchers will also use clinical signs and patient cognitive ability to understand symptom progression. The goal is to improve surgical decision-making and recovery outcomes by identifying clear physical performance benchmarks in DCM patients.