Comparative Effectiveness Of Two Physiotherapy techniques (Deep Cervical Flexor Training And Myofascial Release) in the management of Chronic Neck Pain

INTERVENTION: Intervention1: Deep cervical flexor muscle training alongwith conventional therapy: a. Craniocervical Flexion Exercise (CCFE) Procedure: Patient lies in supine crook lying position Patient performs a gentle chin nod ( yes motion) without activating superficial muscles Hold for 5 10 seconds Perform 10 repetitions Progress gradually as control improves b. Progression of DCF Training Add head lifting while maintaining chin tuck Incorporate into functional positions (sitting/standing) Add resistance using therapist/manual resistance. in addition to this, conventional therapy will be administered which includes Ultrasound therapy, Stretching exercises, and application of hot pack. the stretching exercises will be performed with a dosage of 10‐15 repetitions with each stretch held for 5‐10 seconds. Control Intervention1: Myofascial release alongwith conventional therapy: MFR is a manual therapy technique aimed at releasing fascial restrictions and trigger points. a.. Commonly Treated Areas Upper trapezius Levator scapulae Sternocleidomastoid Suboccipital muscles b. Techniques Used 1. Direct Myofascial Release Therapist applies deep pressure into restricted fascia Moves tissue in direction of restriction 2. Indirect Myofascial Release Gentle stretch applied away from restriction Allows fascia to unwind naturally 3. Suboccipital Release Patient in supine Therapist applies sustained pressure under occiput Helps relieve headache and upper cervical tension 4. Trigger Point Release Sustained ischemic pressure applied to trigger points Held for 20 60 seconds 2 3 sessions per week Each muscle treated for 1 2 minutes Total session: 15 20 minutesIn addition to this, conventional therapy will be administered, which includes ultrasound therapy, stretching exercises, and application o CONDITION: Health Condition 1: M542‐ Cervicalgia PRIMARY OUTCOME: Neck Disability IndexTimepoint: Baseline and at 2 weeks post‐ intervention and then 4 weeks post‐intervention SECONDARY OUTCOME: Neck Disability Inde X; Numeric pain rating scale ; Craniocervical‐flexion testTimepoint: Baseline and at 2 weeks post‐intervention and then 4 weeks post‐intervention INCLUSION CRITERIA: Patients aged between 20‐50 years Primary complaint: the patient reports neck pain as their primary complaint Duration: the pain has been present for a specific amount of time e.g. atleast 8 weeks for chronic pain Pain intensity: pain is measured on a scale or related to functional limitations Functional limitations: the pain limits activities of daily living or is associated with functional disability as measured by tools like neck disability index(NDI)