1. Electrotherapy

2. Exercises.

   • Electrotherapy Hot pack Patients will be in prone position and for relaxation pillow will place beneath the abdomen. Then to reduce muscle spasm and to induce vasodilation hot pack will use for 15 minutes. Treatment with hot pack helps in improving and relaxing the muscle spasm and soft tissue elasticity.

TENS TENS will be of 50 Hz, duration of pulse will be<150 microseconds, for 15 minutes to reduce pain.

TENS and Hot Pack will use at the same time for 15 minutes.

Ultrasound Ultrasound's gel will be applied on outer surface of skin with 2-3 mm thickness. Then ultrasound which frequency will be 1MHz applied for 5 min.

• Exercises Passive Range of Motion exercises for 10 minutes

1. Neck Flexion
2. Neck Side bending
3. Neck Rotation
4. Isometric neck flexion
5. Isometric neck extension
6. Isometric neck side bending

These exercises will repeat 3 times within the treatment program.

The routine physical therapy will be applied first, in which electrotherapy will applied for 20 mins, TENS and hot pack for 15 mins, ultrasound for 5 mins.

Manual therapy

Natural Apophyseal Glides The natural apophyseal glides, which will be applied between C2 and C7, will be the Manual Muscle Testings first action. Patients may request to sit and lean on a chair. The oscillatory motions will reapply the mobilization.

Sustained Natural Apophyseal Glides Sustained Natural Apophyseal Glides will be a mixture of mobilization and active gestures/movements.

5 repetitions for 10 minutes of each.

The routine physical therapy will be applied first, in which electrotherapy will applied for 20 minutes, TENS and hot pack is applied for 15 minutes at the same time, then ultrasound will applied for 5 minutes.

Stretching exercises will be done in the following order;

For trapezius: Stretching into lateral flexion for the upper part, For scalene: rotation and ipsilateral flexion For the extensor muscles: flexion will be performed.

Performing each action for 30 seconds with 5 repetitions for 10 minutes Finally, by retruding the jaw, a neck straightening exercise can be performed.

Routine Physical Therapy treatment with hot pack, TENS, and ultrasound helps in improving and relaxing the muscle spasm and soft tissue elasticity along pain reduction.

A Visual Analogue Scale is a measurement instrument that tries to measure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured.

The Neck Disability Index is a 10-item questionnaire that measures a patient's self-reported neck pain related disability. A higher Neck Disability Index score means the greater a patient's perceived disability due to neck pain

The Bubble Inclinometer precisely measures, tests and evaluates the ranges of motion of neck. While using, place the Inclinometer near the joint to be measured.