Relaxation Techniques in Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis

OBJECTIVE: Although previous evidence has shown positive results of conservative interventions on chronic pain, the specific effect of relaxation techniques on chronic nonspecific neck pain (CNNP) has not been studied. Thus, this study aimed to determine the effectiveness of relaxation techniques on neck pain intensity and pain-related disability in this population. METHOD: We systematically searched five databases from inception to November 2023 for randomized controlled trials comparing the effects of relaxation techniques versus physical therapy interventions and versus control on pain intensity and pain-related disability. A random-effect method was used for pooling the standardized mean difference and its related 95% confidence intervals (CIs) with the DerSimonian–Laird method. Meta-regression models were conducted to determine the influence of age, sex, and intervention characteristics on the effect estimates. RESULTS: A total of 16 studies involving 1,384 adults (aged 30–56 years) with CNNP were included. The pooled standardized mean difference for relaxation techniques versus physical therapy intervention was not significantly different for pain intensity (−0.14; 95% CI = [−0.57, 0.30]) or pain-related disability (−0.02; 95% CI = [−0.37, 0.34]). Compared with the control condition, the relaxation technique significantly improved pain intensity (−0.48; 95% CI = [−0.79, −0.16]) and pain-related disability (−0.45; 95% CI = [−0.79, −0.11]). CONCLUSION: Relaxation techniques should be considered as an effective therapeutic strategy in the rehabilitation of CNNP since they may have a moderate effect on reducing pain and disability compared to the control condition. However, no differences were observed between relaxation techniques and physical therapy interventions. Public Significance Statement: Neck pain is one of the leading causes of morbidity worldwide, and it is associated with substantial socioeconomic costs. Our meta-analysis shows that interventions involving relaxation techniques for at least 4 weeks reduce pain and disability in chronic nonspecific neck pain. We recommend its combination with physical therapy interventions for its benefits and lack of adverse effects.