Clinical Outcomes of Maitland's Mobilization in Patients With Myofacial Chronic Neck Pain

Clinical Outcomes of Maitland's Mobilization in Patients With Myofacial Chronic Neck Pain

Myofacial neck pain is a common musculoskeletal problem caused by presence of trigger points and local and referred pain patterns. Chronic neck pain is responsible for the involvement of joints, ligaments, fascia and connective tissue as well. The objective of this study was to assess the impacts of Maitland's mobilization in patients with myofacial chronic neck pain. Maitland's mobilization is one of the most common manual therapy approaches used by physiotherapists. Maitland's techniques involve the application of passive and accessory oscillatory movements to spinal and vertebral joints to treat pain and stiffness.

In this randomized, placebo treatment controlled trial, 30 patients consecutively aged 25-45 years meeting inclusion criteria were isolated into two groups. The study group was treated with Maitland's mobilization consistently for 8 weeks while the control group got placebo treatment for a similar time frame. Visual analog Scale (VAS), Neck disability index (NDI) and cervical range of motion (ROM) questionnaire was filled by patients before, intermediate and after the intervention to evaluate the severity of pain, functional ability and range of motion.

Inclusion Criteria:

• Patients age between 25-45 years old,
• Bilateral pain involving the upper trapezius and elevator muscle of the scapula;
• Duration of pain of at least 3 months;
• A pain intensity corresponding to at least 2 cm on a 10 cm visual analogue scale (VAS); -Neck pain with symptoms provoked by either neck postures or neck movement;
• Pain localized at least in the cervical and occipital regions but not in the orofacial region; --Neck disability index (NDI) greater than or equal to 15 points;
• Restricted cervical range of movements (flexion, extension, rotation, and side-bending); ---Presence of bilateral MTrPs in upper trapezius and levator scapulae muscles were included in this study.

Exclusion Criteria:

• A history of traumatic injuries (e.g., contusion, fracture, and whiplash injury);
• Systemic diseases such as fibromyalgia, systemic erythematous lupus and arthritis;
• Neurologic disorders (e.g., trigeminal neuralgia or occipital neuralgia);
• Concomitant medical diagnosis of any primary headache (tension type or migraine);
• Cervical spine surgery; and clinical diagnosis of cervical radiculopathy or myelopathy