Patients in this group will receive physiotherapy protocol and medications.

Patients in this group will receive medications only.

Patients in this group will receive physiotherapy protocol and medications.

Patients in this group will receive medications only.

the physiotherapy protocol which will include: 4. Exercise in the form of: d. Breathing exercise e. Aerobic exercise (walking on treadmill with a speed of 3 miles per hour and 0% inclination) f. Bridging exercise 5. Manual techniques in the form of:

1. Suboccipital release
2. Diaphragm release
3. Clavi-pectoral myofascial release 6. Home Routine

c. Hot tub bath for 30 minutes d. Breathing exercise

Assessment will be done by using Arabic version of Beck Depression Inventory (BDI) which is designed to rate the severity of respondents' depression in the weeks preceding questionnaire completion. Each of the 21 questions presents four different statements and asks respondents to select the option that best represents them. Statements refer to depressive states in varying degrees of severity (from "I do not feel sad" to "I am so sad or unhappy that I can't stand it"), and this is reflected in the scoring process which assigns higher values to responses indicating more acute symptoms of depression. The total score can range from 0 to 63 points, with a total score of 0-9 points indicating minimal depression, 10-18 points mild, 19-29 points moderate, and 30-63 points severe depression.