Diaphragmatic Breathing and Electroacupuncture for Chronic Neck Pain

Official title

Diaphragmatic Breathing and Electroacupuncture in Patients With Chronic Neck Pain

Overview

Chronic non specific neck pain is a prevalent musculoskeletal disorder with significant impact on pain, forward head posture, and neck disability. Diaphragmatic breathing has been shown to improve relaxation and reduce musculoskeletal pain, while electroacupuncture has potential benefits in modulating pain pathways. However, the combined effect of these interventions in chronic neck pain remains unexplored. This randomized clinical trial aims to evaluate the effectiveness of diaphragmatic breathing and electroacupuncture, in addition to physiotherapy care, compared to simple, focused breathing, electroacupuncture, and physiotherapy care. The primary outcomes are the numeric pain rating scale (NPRS) and neck disability index (NDI), while secondary outcome include craniovertebral angle (CVA).

Detailed description

Chronic neck pain (CNP) is characterized as persisting pain for more than 3 months, which has a longer expected recovery time. It may be linked to a deficiency or modification of the proprioception of the neck muscles, which is essential for head motor control, cervical joint position, and postural stability (PS). In terms of pain and disability, neck discomfort presents a significant medical problem for patients. According to reports, neck pain is a major cause of illness and a global hardship. The most typical signs of the aforementioned condition are localized, dull, and deep muscle discomfort. Additional symptoms include exhaustion, stiffness, pain, decreased activity, involvement restriction, and difficulty performing coordinated motions.

Standard physiotherapy for persistent neck pain, which includes stretching, isometric exercises, and hot pack therapy, has been shown in recent trials (2021-2024) to effectively reduce pain and improve function. Isometric exercises, self-stretching, active range of motion, heat packs, and self-mobilization methods were all used in this recent randomized controlled experiment.

A breathing technique called diaphragmatic breathing training encourages maximum exhalation, enhances lung ventilation, and facilitates the release of secretions from the trachea. The objectives of these exercises are to modify the recruitment of respiratory muscles, decrease hyperinflation, enhance respiratory muscle function, maximise thoracoabdominal mobility, and lessen dyspnoea. Through diaphragmatic respiration, they can support trunk stability and lung function and posture correction.

CNP is also treated in traditional medicine using various techniques. Electroacupuncture (EA) is one of such techniques; it is safe and doesn't require medication, and numerous studies have shown that it effectively reduces pain and enhances patients' quality of life. Electroacupuncture (EA) is a modified form of acupuncture in which, following a traditional acupuncture procedure, weak electronic currents are applied through the needles.

Interventions

• Other physiotherapy care, diaphragmatic breathing, and electroacupuncture
  * Physiotherapy care: 30 minutes of physiotherapy, including 10 minutes of hot pack, neck isometrics (muscle setting exercises) (10x10) 3 sets for 10 minutes, and stretching exercises for 10 minutes. * Diaphragmatic breathing: 10 min per session in a comfortable supine position or focusing on slow, deep inhalation with diaphragmatic expansion will reduce pain threshold and prepare the patients to receive the electroacupuncture. * Electroacupuncture: Electrical stimulation with acupuncture needle
• Other physiotherapy care, simple focused breathing exercises, and electroacupuncture
  * Physiotherapy care: 30 minutes of physiotherapy, including 10 minutes of hot pack, neck isometrics (muscle setting exercises) (10x10) 3 sets for 10 minutes, and stretching exercises for 10 minutes. * Simple focused breathing exercises: 10 minutes per session of simple, focused breathing exercises. * Electroacupuncture: Electrical stimulation with acupuncture needles will be applied to the targeted muscle group for 10 minutes per session by a certified practitioner. The targeted muscles will be

Primary outcome measures

• Pain Intensity [Time frame: Baseline 1st, 3rd and at 6th week of intervention]
• Neck Disability [Time frame: Baseline 1st, 3rd and at 6th week of intervention]

Secondary outcome measures (1)

• Craniovertebral Angle (CVA) [Time frame: Baseline 1st, 3rd and at 6th week of intervention]

Eligibility criteria

Inclusion criteria

• Patients having a history of the previous 3 months of chronic neck pain
• NPRS 4-7
• Patients having paradoxical breathing
• CVA less than 49 degrees

Exclusion criteria

• Congenital abnormality of the cervical spine
• Post-traumatic neck pain
• Hemorrhagic diseases
• Radiculopathy

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Pakistan · 1 center

• University of Lahore Teaching Hospital — Lahore

Identifiers

NCT: NCT07684092 · UOL/IREB/25/12/0036

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗