Stripping Massage Technique:

• The back of the neck and shoulder were uncovered.
• Controlled and steady pressure was administered using the thumb along the entirety of the tense trapezius muscle, moving from origin to insertion and perpendicular to the muscle fibers, for approximately 3 minutes, twice weekly over a period of 4 weeks.
• The pressure was progressively raised with each subsequent stroke, based on tolerance level.

Post-Isometric Relaxation (PIR):

• During the PIR intervention, the patients rested in a supine position with their necks tilted to the side, away from the affected side, placing the upper trapezius muscle fibers in a stretched position.
• A moderate isometric contraction, around 75% of the patient's maximum effort, was performed by the upper trapezius and maintained for 5 seconds, followed by a 3-second relaxation phase.
• The therapist then gently mobilized the cervical spine to a new range of motion barrier.
• This sequence was repeated four times per session

• The back of the neck and shoulder were uncovered.
• Controlled and steady pressure was administered using the thumb along the entirety of the tense trapezius muscle, moving from origin to insertion and perpendicular to the muscle fibers, for approximately 3 minutes, twice weekly over a period of 4 weeks.
• The pressure was progressively raised with each subsequent stroke, based on tolerance level.

The Numerical Pain Rating Scale (NPRS) is a numeric adaptation of the Visual Analogue Scale (VAS). In this version, the patient selects a number from 0 to 10 that best represents the intensity of their pain. This 11-point scale ranges from "no pain" to "worst pain imaginable," where 0 indicates no pain and 10 signifies extreme pain.

Range of motion (ROM) is a crucial parameter for assessing movement limitations. While clinicians commonly use goniometers to measure ROM, the accuracy of this method largely relies on the clinician's skill and experience.

The NDI (Neck Disability Index) is a condition-specific, patient-completed questionnaire consisting of 10 items designed to evaluate pain and functional status, primarily used for reporting neck pain. Each item on the scale is scored from 0 to 5, with the total score interpreted as a percentage. A score of 0 points (0%) indicates no activity limitation, while a score of 50 points (100%) indicates complete activity limitation. The NDI is a reliable and valid questionnaire for neck pain patients, with interclass correlation coefficients ranging from 0.50 to 0.98