Effects of Different Myofascial Release Techniques on Function in Chronic Non-Specific Neck Pain

This single-center, three-arm randomized controlled trial compares the effects of different myofascial release techniques, combined with a structured exercise program, on functional outcomes in individuals with chronic non-specific neck pain (CNNP). Eligible participants (aged 18 to 45 years, neck pain for at least 3 months, pain intensity VAS at least 3, and myofascial trigger points in the upper-quarter muscles) are allocated by simple randomization into three groups: * Conventional Therapy Group: hot pack, conventional TENS, and a structured exercise program. * Manual Myofascial Release Group: conventional therapy plus therapist-applied manual myofascial release. * Self-Myofascial Release Group: conventional therapy plus supervised self-applied myofascial release using a duo-ball, balls, and a massage stick/cane. All interventions are delivered 3 days per week for 6 weeks. The primary outcome is pain intensity. Secondary outcomes include pressure pain threshold and tolerance, cervical range of motion, muscle stiffness, craniovertebral angle, cervical proprioception, muscle strength and endurance, disability, neck awareness, multidimensional biopsychosocial status, sleep quality, quality of life, and kinesiophobia. The aim is to determine whether manual or self-applied myofascial release, added to exercise, produces greater functional improvement in people with chronic non-specific neck pain.

Inclusion Criteria: * Neck pain persisting for at least 3 months and diagnosed as chronic non-specific neck pain by a specialist physician * Aged between 18 and 45 years * Perceived pain affecting daily living activities (VAS at least 3) * Presence of myofascial trigger points in the upper-quarter muscles Exclusion Criteria: * Specific serious cervical spine pathology (radiculopathy, myelopathy, severe nerve root compression, spondylosis, and similar) * History of rheumatologic, neurologic, or systemic disease (for example, acute inflammation, multiple sclerosis, Parkinson's disease, rheumatoid arthritis, fibromyalgia, or cancer) * History of trauma, fracture, or surgery involving the neck, shoulder, or upper extremity * Pregnancy or breastfeeding * Any diagnosed psychiatric disorder (for example, major depression or anxiety disorder) or regular use of psychopharmacological medication * Use of systemic analgesics, NSAIDs, or muscle relaxants within the last 7 days for pain control * Any physiotherapy, manual therapy, or injection treatment to the neck region within the last 3 months