Effect of Sustained Natural Apophyseal Glide Combined With Strengthening Exercises of Lower Fibers of Trapezius in Patient With Unilateral Neck Pain

Effect of Sustained Natural Apophyseal Glide Combined With Strengthening Exercises of Lower Fibers of Trapezius in Patient With Unilateral Neck Pain

Neck pain is considered one of the very common cause behind musculoskeletal pain and is 4th leading cause of disability . Cervical pain is among 5 most contributing factors in causing years lived with disability.Individuals with unilateral neck pain exhibit significantly less Lower Trapezius strength than Middle and Upper Trapezius fibers .Mulligan is one of the mobilization techniques that can be applied in case of neck pain.In prolong neck pain there is a hyperactivation and shortening of upper trapezius which makes the lower trapezius weak this leads to imbalance between cervical and scapular muscles and result in impaired biomechanics. So mostly treatment focused on upper trapezius and neglecting the lower trapezius and this create increase chances of recurrency of neck pain because the imbalance remains present. So, this study aims at evaluating the effects of SNAGS combined with strengthening exercises of lower fibers of trapezius .

Inclusion Criteria:

• Individuals aged 18-35 years
• Both gender
• Unilateral neck pain
• Symptoms of duration more than 3 months.
• NPRS scoring of greater than or equal to 4 points.
• Neck disability index score of 20% or above.
• Manual muscle testing : grade 3

Exclusion Criteria:

• Prior cervical and thoracic spine fractures, dislocations, or surgeries, spinal osteoporosis or infection, or whiplash.
• Any trauma or localized infection in neck region
• Psychiatric diseases such as phobia/obsession and depression