<b>Comparative Effects of Graston Technique and Manual Soft Tissue Release on Pain and Range of Motion in Patients with Tension Neck Syndrome</b>

Background: Tension Neck Syndrome is a common musculoskeletal condition characterized by neck pain, muscular stiffness, myofascial tenderness, and restricted cervical mobility. Manual Soft Tissue Release and the Graston Technique are frequently used physiotherapy interventions, but direct comparative evidence remains limited. Objective: To compare the short-term effects of the Graston Technique and Manual Soft Tissue Release on pain intensity and cervical range of motion in patients with Tension Neck Syndrome. Methods: Ethical approval was obtained from the Ethics Committee of Green International University. The trial was registered under registration number NCT07602972. This parallel-group randomized controlled trial included 40 participants with Tension Neck Syndrome, who were allocated equally to the Graston Technique group and the Manual Soft Tissue Release group. Both groups received moist heat and transcutaneous electrical nerve stimulation, followed by their allocated intervention, for 12 sessions over four weeks. Pain intensity was measured using the Numerical Pain Rating Scale, and cervical range of motion was assessed using a bubble inclinometer at baseline and after the intervention Results: Both groups showed significant improvement after treatment. NPRS pain score decreased by 4.85 ± 0.72 points in the Graston Technique group and 3.25 ± 0.84 points in the Manual Soft Tissue Release group, with a between-group mean difference of 1.60 points favoring the Graston Technique. Cervical ROM improved in all directions in both groups, with greater gains after the Graston Technique; between-group differences ranged from 3.25° for flexion and left lateral flexion to 7.45° for right rotation. Conclusion: The Graston Technique produced greater short-term improvement in pain and cervical mobility than Manual Soft Tissue Release in patients with Tension Neck Syndrome.