A Study to Compare the Effectiveness of McKenzie Neck Exercise and Contract Relax Stretching in Mechanical Neck Pain

Background: Mechanical neck pain is commonly defined as pain between the superior nuchal line and an imaginary transverse line through the tip of the first thoracic spinous process, extending laterally to the sagittal planes peripheral to the lateral borders of the neck. Neck pain (NP) can be local and/or referred into the head and/or upper limbs. NP is a prevalent musculoskeletal issue worldwide, similar to low back pain (LBP), characterized by episodic occurrences with high recurrence and chronicity rates. It frequently arises insidiously and is multifactorial in origin, with modifiable factors including smoking, poor posture, anxiety, depression, neck strain, and occupational activities. NP is a significant societal burden, particularly prevalent among office workers and computer users. Objective: The objective of this study was to compare the effectiveness of McKenzie neck exercises and contract-relax stretching in alleviating mechanical neck pain. Methods: This quasi-experimental study included 40 participants aged 25 to 50 years from Allied Hospital Faisalabad, selected using purposive sampling. Participants were divided into two groups of 20 each. Group 1 received McKenzie neck exercises, while Group 2 received contract-relax stretching. Both groups underwent treatment three times per week for 6 to 8 weeks. Pain and functional performance were evaluated using the Numeric Pain Rating Scale (NPRS) and Neck Disability Index (NDI). Statistical analysis was conducted using SPSS version 27.0, with the Wilcoxon signed-rank test applied for within-group comparisons and the Mann-Whitney U test for between-group comparisons. Results: In Group 1 (contract-relax stretching), NPRS scores improved from a mean of 2.56 (SD=0.51) to 2.11 (SD=0.47) (Z=-2.828, p<0.05), and NDI scores improved from a mean of 3.78 (SD=0.55) to 0.73 (SD=0.73) (Z=-3.419, p<0.05). In Group 2 (McKenzie neck exercises), NPRS scores improved from a mean of 2.61 (SD=0.50) to 1.72 (SD=0.57) (Z=-2.828, p<0.01), and NDI scores improved from a mean of 3.22 (SD=0.73) to 2.06 (SD=0.94) (Z=-3.391, p<0.05). Between-group comparisons indicated that Group 2 had significantly greater improvements in NPRS (mean rank 15.47 vs. 21.53, p<0.05) and NDI scores (mean rank 13.86 vs. 23.14, p<0.05). Conclusion: Both McKenzie neck exercises and contract-relax stretching effectively reduced pain and improved function in patients with mechanical neck pain. However, McKenzie neck exercises demonstrated significantly greater improvements in pain relief and functional outcomes. Therefore, McKenzie neck exercises may be preferred for managing mechanical neck pain. Keywords: Mechanical Neck Pain, McKenzie Neck Exercise, Contract-Relax Stretching, Numeric Pain Rating Scale, Neck Disability Index