Sustained Natural Apophyseal Glides With and Without Integrated Neuromuscular Inhibition Technique in Neck Pain

Effects of Sustained Natural Apophyseal Glides With and Without Integrated Neuromuscular Inhibition Technique on Pain, Range of Motion, and Function in Patients With Chronic Mechanical Neck Pain

The study was conducted to determine the effects of Sustained Natural Apophysial Glide with and without Integrated Neuromuscular Inhibition Technique on pain, range of motion and function in patients with chronic mechanical neck pain

Inclusion Criteria:

• Age ranged from 18 to 45 years and both genders.
• Patient having neck-pain symptoms for more than 3 months duration.
• Spurling test, distraction test, upper limb tension test and shoulder abduction test negative upon assessment.
• The participants should have MTrPs in any one of these following cervical muscles which include levator scapulae, upper trapezius, splenius capitis and sternocleidomastoid muscles which may be active or latent.
• A score greater than twenty percent on NDI.
• Jump Sign when pressure is applied.
• Positive Simons criteria which contains following these 5 characteristics :(1) Pain on palpation (2) pain that is radiating (3) Tightened cord like structure in muscle fiber that is detectable upon palpation(4) Reduced Flexibility of that muscle (5) 'twitching response' on needling.
• Participants who described pain which is felt between spinous process of 1st thoracic vertebrae and superior nuchal line in posterior or posterolateral part of neck

Exclusion Criteria:

• Recent fracture, trauma (whiplash injury) and surgery in and around the shoulder and neck
• Neural disorders due to prolapsed intervertebral disc
• Carcinoma, Heart diseases, Metabolic disease in bone and joints
• Patients having history of osteoporosis, prolong steroid and analgesics use
• Unstable spine and open sores, Localized infection in neck
• Vertebrobasilar insufficiency.
• Cervical radiculopathy and myelopathy