Diaphragmatic Myofascial Release Added to Neck Exercises for Chronic Neck Pain

Chronic neck pain can affect daily activities and may be associated with pain, disability, fear of movement, and fatigue. Exercise is commonly used to manage chronic neck pain, but some people continue to experience symptoms despite exercise treatment. This study will investigate whether adding diaphragmatic myofascial release, a hands-on manual therapy directed toward the diaphragm and surrounding tissues, to a neck exercise program provides greater benefits than neck exercises alone in adults with chronic neck pain. Sixty adults aged 25 to 60 years with chronic neck pain lasting more than three months will be randomly assigned to one of two groups. The control group will receive a supervised neck exercise program, while the intervention group will receive the same neck exercise program combined with diaphragmatic myofascial release and related diaphragmatic manual therapy. Both groups will receive treatment for six weeks, with three supervised sessions per week. Pain, neck-related disability, fear of movement, and fatigue will be assessed before treatment, immediately after the six-week intervention, and four weeks after completion of treatment. The study will examine whether adding diaphragmatic myofascial release to neck exercises leads to greater improvements in these outcomes compared with neck exercises alone.

Inclusion Criteria: * Men and women aged 25-60 years. * Diagnosis of chronic neck pain lasting longer than 3 months. * Ability to understand and follow instructions. Exclusion Criteria: * Previous cervical spine surgery. * Cervical radiculopathy or myelopathy. * History of fracture, inflammatory disease, malignancy, or neurological disorder. * Respiratory diseases such as chronic obstructive pulmonary disease (COPD) or severe asthma. * Current vestibular disorder. * Pregnancy. * Receipt of physical therapy or manual therapy during the previous 3 months.