Comparison of Suboccipital Release and Muscle Energy Technique in Subjects With Mechanical Neck Pain and Forward Head Posture

This study will compare two physiotherapy treatments for adults with long-lasting neck pain and tender muscle spots, called trigger points, in the upper trapezius muscle between the neck and shoulder. The aim is to find out which treatment was more effective in reducing pain, improving neck movement, and reducing difficulty with daily activities. The study will includ 76 adults aged 20-40 years at Mayo Hospital, Lahore, Pakistan. Participants will be assigned by chance to one of two treatment groups. One group will receive a cooling spray followed by gentle stretching of the affected muscle. The other group will receive sustained pressure applied by a therapist to the tender muscle spots. Both groups also will receive routine physiotherapy, including heat, exercises, and advice about neck care and posture. Participants will receive six treatment sessions over two weeks. Pain, neck movement, and difficulty with daily activities will be assessed before treatment, immediately after the first session, and after the sixth session.

Inclusion Criteria:Adults aged 20-40 years, of either sex. Chronic mechanical neck pain lasting at least three months. At least one upper trapezius trigger point with painful restriction of cervical range of motion. Forward head posture. Pain intensity below 7 on the 0-10 Visual Analogue Scale. - Exclusion Criteria:Fibromyalgia. Previous cervical spine surgery. Thoracic outlet syndrome. Cervical radiculopathy. Skin infection or open wounds in the cervical region. Cervical tumour. Cervical spine fracture. Use of steroid therapy. \-