Comparative Effectiveness of McKenzie Protocol and Myofascial Release Therapy to Improve Functional Outcomes in Patients with Mechanical Neck Pain

Abstract

Background: Mechanical neck pain is a common musculoskeletal disorder associated with posture, repetitive strain, and degenerative changes, often leading to disability and reduced quality of life (1,2). Conservative management includes exercise- and manual-based therapies, yet evidence comparing different interventions remains limited. The McKenzie Method emphasizes repeated movement testing, directional preference, and patient self-management, whereas Myofascial Release Therapy targets fascial restrictions through sustained manual pressure (17,20). Objective: To compare the effectiveness of McKenzie protocol and Myofascial Release Therapy in improving pain, functional disability, and cervical range of motion among patients with mechanical neck pain. Methods: A quasi-experimental trial was conducted at Government College University Faisalabad between January and June 2023. Forty participants with mechanical neck pain were randomly allocated to McKenzie exercises (n=20) or Myofascial Release Therapy (n=20). Interventions were delivered thrice weekly for six weeks. Pain intensity (Numeric Pain Rating Scale), functional disability (Neck Disability Index), and cervical range of motion (goniometry) were assessed at baseline and six-week follow-up. Data were analyzed using repeated-measures and mixed-model ANOVA. Results: Both groups improved significantly over six weeks, but McKenzie produced greater reductions in pain (−3.6 vs. −2.3 points) and disability (−15.6 vs. −4.4 points). Cervical motion gains were nearly twofold higher with McKenzie, especially in flexion and rotation (p<0.01). Conclusion: McKenzie protocol provided superior outcomes compared with Myofascial Release Therapy, supporting its role as a first-line intervention for mechanical neck pain.