RecruitingNot ApplicableNCT06996015

Effects of SNAGs & CBT on Pain, Craniovertebral Angle & Disability in Non Specific Neck Pain

Effects of SNAGs and Cognitive Behavior Therapy on Pain, Craniovertebral Angle and Disability in Patients With Non-Specific Neck Pain

Sponsor

Riphah International University

Enrollment

32 participants

Start Date

Jun 10, 2025

Study Type

INTERVENTIONAL

Conditions

Cognitive Behavior Therapy Neck Pain Cervicalgia Posture Posterior Neck Pain Neck Pain and Forward Head Posture

Summary

Non-specific neck pain is a prevalent condition causing discomfort, reduced craniovertebral angle, and disability. This randomized controlled trial will evaluate the combined effects of Sustained Natural Apophyseal Glides (SNAGs) and Cognitive Behavioral Therapy (CBT) on pain, posture, and function. Group A will receive SNAGs and CBT, while Group B will undergo SNAGs with cervical stabilization exercises, twice weekly for four weeks. Outcomes will include pain, craniovertebral angle, and disability, analyzed using SPSS.

Eligibility

Min Age: 18 YearsMax Age: 28 Years

Inclusion Criteria7

Age group: 18-28 Years(20)
Gender Group: Both male and female participants(20)
Individuals with a Craniovertebral angle \<53(20)
Individuals having grade 2 neck pain according to KNGF Guidelines.(21)
Individuals having localized pain or stiffness in spine or both combined between C3 and C7 without upper-limb radiculopathy(22)
Individual who had not received any treatment for neck pain for the last 3 months will be included in the study.
Patients willing to sign written consent form.

Exclusion Criteria7

Those who had undergone spinal surgery(23)
Neck pain caused by various pathologies (rheumatoid arthritis, ankylosing spondylitis, fracture, tumor, etc.)(23)
Nerve root compression, (23)
A positive vertebrobasilar artery test, (23)
Severe radiculopathy,(23)
Osteoporosis, or osteopenia(23)
Long-term use of corticosteroids or anticoagulants (23)

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Interventions

OTHERCognitive behavior therapy

The treatment session will begin with a 10-minute conventional therapy, including a 5-minute hot pack applied to the cervical region and a 5-minute Myofascial Release (MFR) using skin rolling and cross-hand techniques to relax and stretch the fascia layers. This will be followed by a 10-minute application of Sustained Natural Apophyseal Glides (SNAGs), where the physiotherapist will guide the patient's active neck movements with accessory glides to improve joint ROM and reduce pain. Lastly, a 20-minute Cognitive Behavioral Therapy (CBT) session will include visual aids, explanations of cervical spine biomechanics, pain pathways, ergonomics, and posture management. Patients will receive manuals summarizing key points and be encouraged to engage actively. The 40-minute session will be conducted twice weekly for four weeks

OTHERCervical Stabilization Exercises

The treatment session will last 40 minutes, twice a week for 4 weeks. It begins with a 10-minute conventional treatment: a 5-minute hot pack application to the cervical region followed by a 5-minute Myofascial Release (MFR) using the skin rolling technique. Natural wax will be applied for smooth strokes. MFR will engage all fascia layers with superficial strokes, progressing to deeper fascia using cross-hand stretch, depending on the pain tolerance. Next, SNAGs (Sustained Natural Apophyseal Glides) will be applied for 10 minutes. The patient, seated, will actively move the painful joint through its range of motion while the therapist applies a glide force. This will be repeated 10 times for 3 sets. Then session includes 20 minutes of Cervical Stabilization Exercises (CSE) with bracing in neurodevelopment stages (supine, prone, quadrupedal, bipedal), holding each position for 10 seconds. Isometric exercises and functional training with elastic bands and exercise balls follow.