Efficacy of Integrated Neuromuscular Inhibition Technique and Neurodynamic Mobilization on Pain, Function and Neck Mobility among Patients with Mechanical Neck Pain: A Randomized Controlled Trial

Abstract

Background: Mechanical neck pain is a prevalent musculoskeletal disorder often associated with myofascial trigger points, restricted mobility, and neural mechanosensitivity. Integrated Neuromuscular Inhibition Technique (INIT)- combining ischemic compression, strain–counter strain, and muscle energy technique, has shown promising effects in reducing pain and improving function, also Neurodynamic mobilization has been proven to restore optimal neural tissue mobility and reduce mechanosensitivity. Objective: To investigate the combined effect of INIT and neurodynamic mobilization on pain, Cervical Range of Motion (CROM), and functional disability in individuals with mechanical neck pain. Methods: A randomized controlled trial was conducted on participants aged 20–50 years with unilateral mechanical neck pain for more than four weeks and presence of upper trapezius trigger points. Total Participants (n = 30) were randomly and equally allocated (15 in each group) into Group A (INIT + neurodynamic mobilization) and Group B (INIT alone). Interventions were administered thrice weekly for four weeks. Outcome measures included Visual Analog Scale (VAS), Neck Disability Index (NDI), and CROM measured using a goniometer. Assessments were performed at baseline, 2nd and 4th week. Results: Group A showed significantly greater improvement in pain reduction, functional ability, and CROM compared to Group B (p < 0.05). Between-group analysis revealed superior outcomes for INIT combined with neurodynamic mobilization across all measured domains. Conclusion: The INIT combined with neurodynamic mobilization is more effective than INIT alone in managing mechanical neck pain. The integrated approach may enhance neural mobility and reduce myofascial dysfunction more efficiently.