Whiplash

This research aims to compare two manual therapy techniques, Active Release Technique and Strain-Counterstrain, in adults aged 18 to 45 years who experience non-specific neck pain. The study focuses on how these treatments affect pain levels, neck range of motion, the cranio-vertebral angle, and disability. Neck pain is a common problem worldwide and in Pakistan, often caused by muscle strain or poor posture, leading to discomfort and reduced quality of life. This trial seeks to provide insights into which technique may better improve symptoms and function in affected individuals. Participants will be randomly assigned to one of two groups. Group A will receive the Active Release Technique applied to the trapezius, levator scapulae, sternocleidomastoid, and suboccipital muscles for 15 minutes. Group B will receive the Strain-Counterstrain technique on the same muscles and for the same duration. Both groups will also receive hot packs, stretching of superficial neck muscles, and neck isometric exercises. Treatments will be given over four weeks, with assessments at the start and end of this period. During the study, participants will be evaluated for pain using the Numeric Pain Rating Scale, neck disability with the Neck Disability Index, neck posture by measuring the cranio-vertebral angle, and neck mobility with a goniometer. These measurements will be recorded at the beginning and after four weeks of treatment. The study will be conducted at Safi Teaching Hospital in Faisalabad, Pakistan, with ethical approval and informed consent. The findings aim to help improve clinical care for people with non-specific neck pain by identifying more effective manual therapy options.

Researchers are comparing the immediate effects of two types of exercises, motor imagery and motor control, on people with chronic neck pain. The study focuses on how these exercises influence pain levels, pressure pain threshold, neck position sense (cervical proprioception), and the ability to imagine movements (motor imagery). The goal is to better understand which exercise may help manage chronic neck pain symptoms. Participants will be randomly assigned to receive either a single session of motor imagery exercise based on the PETTLEP model or a single session of motor control exercise. Both interventions are studied as experimental approaches to see their acute impact on pain and motor functions related to chronic neck pain. During the study, participants will have their pain severity, pressure pain threshold, cervical proprioception, and motor imagery abilities measured before and immediately after the exercise session. This helps researchers evaluate the immediate changes caused by the interventions. The study enrolls adults aged 18 to 65 with chronic neck pain lasting at least 12 weeks and a specific pain intensity and cognitive function level.

Researchers are investigating the immediate effects of myofascial release therapy on neck pain, functional ability, and neck movement in people diagnosed with Text Neck Syndrome (TNS). TNS is a condition caused by prolonged forward head posture from excessive use of smartphones and other digital devices, especially among young adults. The study aims to explore how a single session of myofascial release might influence symptoms like neck pain and disability in this population. The treatment involves one session of standardized myofascial release techniques applied to the neck and upper back areas. A trained physiotherapist will perform four specific techniques: Single Arm Pull, Lateral Neck Shoulder Release, Thoracic Transverse Release, and Anterior Cervical Release. Each technique lasts about 90-120 seconds and is applied to both sides when appropriate. This study focuses on observing immediate changes before and after this therapy session. Participants will undergo assessments of neck pain intensity using the Numeric Rating Scale, functional disability using the modified Neck Disability Index, and cervical range of motion. These measurements will be taken right before and immediately after the intervention. The study includes volunteers aged 18 to 40 who use mobile devices for more than three hours daily and show symptoms of TNS. The findings will help inform future research and treatment approaches for posture-related neck problems.

This research focuses on chronic whiplash-associated disorder (WAD), a condition caused by rapid neck movement leading to injury of bones or soft tissues and resulting in symptoms like pain and reduced neck movement. The study aims to evaluate the position and alignment of the Atlas (C1 vertebra) in people with chronic WAD compared to those with tension headaches and healthy individuals. It also explores how these factors relate to pain intensity, neck movement limits, daily activities, overall improvement, and quality of life. Participants include healthy controls, patients with chronic WAD (grades 1 or 2), and individuals with tension headache. The study uses advanced MRI imaging to assess the Atlas and surrounding tissues without any intervention. It will measure the feasibility and repeatability of MRI in healthy controls and compare MRI findings among the three groups. The study also collects neurological exam results and patient-reported outcome questionnaires. Participants will undergo MRI scans and neurological exams at specified intervals up to 18 months, with some measures extending to 24 months. Researchers will evaluate repeatability of MRI measurements, alignment of the Atlas, neurological scores, quality of life, muscle volume, fat accumulation, and blood flow. The study includes healthy volunteers aged 18 to 75 years and monitors participants through questionnaires and imaging to understand the relationship between anatomical changes and symptoms in chronic WAD.

Researchers are studying adults aged 18 to 75 who have a history of long-term opioid use to see if a combined behavioral and drug treatment can reduce opioid use, improve pain recovery, and prevent opioid misuse after elective surgery. This clinical trial compares Motivational Interviewing with guided opioid tapering plus tizanidine against Motivational Interviewing with placebo and Enhanced Usual Care to understand which approach best helps patients return to their preoperative opioid use level or stop opioids faster. The study addresses an important need for better postoperative pain care for patients already using opioids long term. The trial has three groups: one receiving Motivational Interviewing-guided opioid tapering with tizanidine; another receiving the same counseling with placebo; and a control group receiving Enhanced Usual Care focused on education about opioid use and pain management. Participants take the study medication (tizanidine or placebo) three times daily for five weeks if in the drug groups. Weekly phone or video visits with clinicians occur for six weeks starting two weeks after surgery, plus an additional follow-up call at week 11. Participants complete a phone assessment and baseline survey before surgery, then weekly online surveys for six months and monthly surveys up to one year after surgery to track opioid use, pain, and related outcomes. Researchers monitor time to return to baseline opioid use as the main outcome, along with opioid cessation, pain resolution, and opioid misuse. The study includes detailed assessments and follow-up over 12 months to understand how these interventions work and their potential for wider use.

This research aims to evaluate the safety and effectiveness of the CEM-Cage combined with the CEM-Plate in patients undergoing a two-level anterior cervical discectomy and fusion (ACDF). It is a first-in-human, prospective, multi-center, non-randomized, single-arm study involving fifty patients with cervical spine conditions such as radiculopathy or myelopathy. The study is designed to provide important information about the device's performance in treating cervical degenerative disc disease. Participants will undergo a two-level ACDF surgery using the CEM-Plate Anterior Cervical Plating System and the CEM-Cage Cervical Interbody System. After surgery, patients will have follow-up visits at 4 weeks, 3 months, 6 months, 12 months, 18 months, and 24 months. These visits include assessments such as quality of life surveys and imaging tests like lateral cervical x-rays to check the device placement and spinal fusion progress. Throughout the study, researchers will monitor for fusion success and overall outcomes, including the absence of serious adverse events or need for additional surgeries at the treated levels. Safety and device-related complications will be tracked for up to 24 months. Participants' quality of life and spine function will be regularly evaluated, helping to understand the long-term effects of the device.

Researchers are investigating the effect of a treatment called Chitosan Phonophresis on cervical pain and disability in young people addicted to smartphones. This condition involves neck pain related to prolonged smartphone use, which can cause local inflammation and nerve damage. Chitosan is a material known for reducing inflammation and pain by suppressing certain immune responses and swelling in nerves. The study divides participants into two groups randomly. One group will follow a selected neck exercise and electrotherapy program, while the other group will receive the same exercise program plus Chitosan Phonophresis treatment three times per week for four weeks. This approach aims to evaluate the additional impact of Chitosan Phonophresis on neck pain and disability. Participants will be monitored over four weeks with assessments including the Smartphone Addiction Scale-Short Version, visual analogue scale for pain, neck disability index, and cervical range of motion. These measurements will help evaluate changes in pain levels, neck function, and smartphone addiction severity. The study starts with a screening process and concludes after the four-week intervention period.

Researchers are evaluating the combined effect of chiropractic care and Tai Chi training on reducing pain and disability in adults with chronic non-specific neck pain. This pilot study aims to assess the feasibility of recruiting, retaining, and safely monitoring participants, while also measuring clinical outcomes such as pain levels, disability, quality of life, self-efficacy, and psychological factors related to neck pain. The study is sponsored by Harvard University Faculty of Medicine and involves adults aged 18 to 65 with persistent neck pain. Participants will be randomly assigned to one of three groups: one group will receive 10 chiropractic treatments over 16 weeks along with Tai Chi group training for 16 weeks and enhanced usual care, which includes educational materials; a second group will receive chiropractic care plus enhanced usual care; and a third group will receive only enhanced usual care with educational materials and biweekly check-in calls. Chiropractic care includes posture correction, soft tissue release, spinal manipulation, education, strengthening, and ergonomic advice. Tai Chi classes will be held weekly for 16 weeks. During the study, participants will be assessed at baseline, 16 weeks, and 24 weeks for pain intensity, pain on movement, disability, quality of life, self-efficacy, postural awareness, pain catastrophizing, fear of movement, and interoceptive awareness. Researchers will also monitor recruitment, retention, and adherence rates throughout the average 18-month study duration. Participants will be followed for 8 weeks after interventions end to evaluate longer-term outcomes and safety.

Chronic nonspecific neck pain is a common musculoskeletal disorder often following low back pain. This research evaluates the effects of central nervous system-focused therapies, including pain neuroscience education, breathing exercises, and relaxation with guided imagery, alongside traditional physiotherapy. The study aims to explore how these therapies impact pain, neck movement, function, fear related to pain, anxiety, depression, and quality of life in affected adults. Participants will receive conventional physiotherapy five days a week for one month, involving treatments like electrical nerve stimulation, heat packs, joint mobilizations, myofascial release, and prescribed neck exercises. One group will also receive additional central nervous system-focused treatments targeting brain mechanisms associated with chronic pain. No medications will be given, and patients will be asked to avoid medication use during the study. Throughout the four-week study, participants will undergo assessments measuring pain levels, neck range of motion, pressure pain threshold, disability, pain-related fear, anxiety, depression, quality of life, sleep quality, central sensitization, and patient satisfaction. These evaluations will monitor changes from the start to the end of treatment, helping researchers understand the impact of the therapies on chronic neck pain and related symptoms.

Forward Head Posture (FHP) is a common postural problem among young adults caused by prolonged screen use and poor sitting habits. This condition, where the head is positioned forward relative to the shoulders, can lead to neck pain, a smaller craniovertebral angle (CVA), and muscle imbalances. The study evaluates the combined effect of Kendall exercises and wearable vibrotactile feedback sensors on correcting FHP, reducing neck pain, and improving CVA and muscle thickness in young adults aged 18 to 30 years. Participants are divided into two groups: one group receives wearable vibrotactile feedback sensors along with Kendall exercises, and the other group performs Kendall exercises alone. The Kendall exercise program includes strengthening deep cervical flexors, stretching cervical extensors, strengthening shoulder retractors, and stretching pectoral muscles. Exercises are done three times a week for 30 minutes over a period of four weeks. During the 12-month study, participants will be assessed for neck pain and craniovertebral angle from baseline to the fourth week. Additional evaluations include the Neck Disability Index. The study uses randomized allocation and single masking. Data will be analyzed using SPSS software. Researchers will monitor postural improvements, pain reduction, and muscle changes to better understand the combined effect of exercises and wearable sensors on FHP correction.