An interventional study of Cervical SNAGS and thoracic manipulation with conventional physiotherapy and Cervical SNAG Mobilization Alone + Conventional Physiotherapy in Non Specific Neck Pain, sponsored by University of Management and Technology Lahore. Not yet recruiting at 1 site in Pakistan. Open to participants aged 20 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-11-02.
Sponsored by University of Management and Technology Lahore · Not applicable, Interventional, and Treatment
Non-specific neck pain is a pain and discomfort in the cervical spinal area that arises without trauma, clearly identifiable pathological cause such as fracture infection, nerve root compression, inflammatory disease or serious structural abnormality. Frequent smartphone use in a pathological way forces the user to adopt a compromised posture, gradually resulting in changes to both the postural and musculoskeletal systems. The incidence of non-specific neck pain (NSNP) makes up approximately 25% of all outpatients in general clinics and 12-70% of the general population. According to symptom duration, Chronic non-specific neck pain is usually classified as pain lasting or recurring for > 3 months. Techniques such as SNAG mobilization and thoracic manipulation may also improve posture and cervical biomechanics by restoring normal spinal mobility. The objective of this study will be to compare the effects of Cervical, Sustain Natural Apophyseal Glide with and Without Thoracic Spine Manipulation on Pain, Range of Motion and Neck Disability in Smartphone Users with Non-Specific Neck Pain. Study design will be randomized clinical trial. Evaluation will be done by using NPRS, NDI and smartphone inclinometer. Non-probability convenient sampling will be used and the subjects will be allocated to two groups by random allocation. Group A will receive cervical SNAG and thoracic manipulation along with conventional physiotherapy and Group B will receive cervical SNAGS alone with conventional physiotherapy. Both groups will receive 12 sessions for the period of 4 weeks. Measurements of all the outcome variables will be taken at baseline, 2nd and 4th week. Results will be analyzed by using SPSS 24
1,269 studies on the registry are indexed under Neck Pain; 259 are open to participants now.
This study's planned enrollment of 60 is above the median of 52 across 1,034 interventional studies indexed under Neck Pain.
Browse Neck Pain studies →University of Management and Technology Lahore is the lead sponsor of 34 studies on the registry; 19 are open to participants now.
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Non-specific neck pain patients aged ≥ 20 to 50 years old (4). Both genders. Mild to moderate neck with NPRS pain score value of between 3/10 - 6/10. Patients with chronic non-specific neck pain (>=12 weeks) Individuals using smartphone for at-least 3-4 hours daily for the last 6 months
Exclusion Criteria:
Any cervical pathology such as cervical fracture, tumor, infection, Inflammatory disease or myelopathy.
Cervical radiculopathy or neurological signs Previous cervical spine surgery Any systemic or rheumatologic disease such as arthritis, ankylosing spondylitis, fibromyalgia or osteoporosis.
Having red flag symptoms such as unexplained weight loss, fever, cancer history, night pain or any vertebral artery insufficiency symptoms.
Any ongoing concurrent treatment such as other physiotherapy, chiropractic treatment or strong analgesic regimens
Participants in Group A will receive Cervical Sustained Natural Apophyseal Glide (SNAG) mobilization combined with thoracic spine manipulation along with conventional physiotherapy treatment. * Cervical SNAG Mobilization Cervical SNAG mobilization will be applied according to Mulligan's concept in a pain-free direction. The therapist will apply a sustained facet glide while the participant actively performs the restricted cervical movement (flexion, extension, rotation, or side bending). There will be 3 sets of 6-10 repetitions per movement. The hold duration will be 3-5 seconds with the rest interval of 30 seconds between sets. * Thoracic Spine Manipulation High velocity low amplitude (HVLA) thoracic manipulation will be applied to the upper thoracic region (T1-T4/T6) with the participant in prone lying position. Manipulation frequency will be 1-2 thrusts per session and target region will be upper thoracic hypomobile segments.
Other: Cervical SNAGS and thoracic manipulation with conventional physiotherapy
Participants in Group B will receive Cervical Sustained Natural Apophyseal Glide (SNAG) mobilization alone along with conventional physiotherapy treatment. Cervical SNAG mobilization will be applied according to Mulligan's concept in a pain-free direction. The therapist will apply a sustained facet glide while the participant actively performs the restricted cervical movement (flexion, extension, rotation, or side bending). There will be 3 sets of 6-10 repetitions per movement. The hold duration will be 3-5 seconds with the rest interval of 30 seconds between sets.
Other: Cervical SNAG Mobilization Alone + Conventional Physiotherapy
Participants in Group A will receive Cervical Sustained Natural Apophyseal Glide (SNAG) mobilization combined with thoracic spine manipulation along with conventional physiotherapy treatment. * Cervical SNAG Mobilization Cervical SNAG mobilization will be applied according to Mulligan's concept in a pain-free direction. The therapist will apply a sustained facet glide while the participant actively performs the restricted cervical movement (flexion, extension, rotation, or side bending). There will be 3 sets of 6-10 repetitions per movement. The hold duration will be 3-5 seconds with the rest interval of 30 seconds between sets. * Thoracic Spine Manipulation High velocity low amplitude (HVLA) thoracic manipulation will be applied to the upper thoracic region (T1-T4/T6) with the participant in prone lying position. Manipulation frequency will be 1-2 thrusts per session and target region will be upper thoracic hypomobile segments.
Participants in Group B will receive Cervical Sustained Natural Apophyseal Glide (SNAG) mobilization alone along with conventional physiotherapy treatment. Cervical SNAG mobilization will be applied according to Mulligan's concept in a pain-free direction. The therapist will apply a sustained facet glide while the participant actively performs the restricted cervical movement (flexion, extension, rotation, or side bending). There will be 3 sets of 6-10 repetitions per movement. The hold duration will be 3-5 seconds with the rest interval of 30 seconds between sets
NUMERIC PAIN RATING SCALE
Numeric Rating Scale (NPRS) is most frequently used instruments to measure pain intensity in low back pain (LBP). The 11-point numeric with 0 representing No pain, 1-3 representing Mild Pain (nagging, annoying, interfering little with ADLs), 4-6 representing Moderate Pains (interferes significantly with ADLs), 7-10 representing Sever Pain (disabling, unable to perform ADLs).
Time frame: baseline and after 4 weeks
The Neck Disability Index (NDI)
The Neck Disability Index (NDI) is a ten-item questionnaire based on the Oswestry Low Back Pain Index that assesses disability associated with neck pain and whiplash. It is the most widely used and most strongly validated instrument for assessing self-rated disability in patients with neck pain. It has been used effectively in both clinical and research settings in the treatment of this very common problem. (16) There are four items that relate to subjective symptomatology (pain intensity, headache, concentration, sleeping) and six items that relate to activities of daily living (lifting, work, driving, recreation, personal care, reading). The questionnaire requires only 5-10 minutes to complete and score, and requires no special training to administer. A score of less than 4 indicates no disability, 5-14 mild disability, 15-24 moderate disability, 25-34 severe disability, and scores greater than 35 complete disabilities
Time frame: baseline and after 4 weeks
SMARTPHONE INCLINOMETER
Cervical range of motion (ROM) is commonly assessed using instruments such as the Universal Goniometer and smartphone-based inclinometers. Cervical range of motion (ROM) in the present study will be measured using a smartphone-based digital inclinometer application. Smartphone inclinometers utilize built-in accelerometer and gyroscope sensors to provide objective angular measurements in degrees. Recent evidence supports their validity and reliability for cervical ROM assessment in both clinical and research settings. A systematic review by Elgueta (18) reported that smartphone applications demonstrated good to excellent reliability and acceptable validity for measuring cervical ROM. Similarly Romero found that smartphone-based applications showed high concurrent validity and excellent intra- and inter-rater reliability for cervical ROM measurements.(19) Furthermore, Huang concluded that smartphone integrated inclinometers provide accurate, reliable, rapid, and convenient assessment o
Time frame: baseline and after 4 weeks
Plan to share: Yes — The results data collected, de-identified individual participant data will be shared.
Supporting information: Study protocol, Statistical analysis plan, Informed consent form
Time frame: 6 months after the publication of the manuscript.
Access criteria: The data can be requested from the corresponding author.
Start is estimated for Oct 2026; primary completion for Dec 2026, 2 months later.
Of 696 non-industry interventional studies with no phase under Neck Pain, half reached primary completion within 7 months of starting (the median), counting those still running; a quarter within 3 and three quarters within 14. This study's planned 2 months is below that.
Counting every sponsor, half of 704 studies reached it within 7 months; a quarter within 3 and three quarters within 15.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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University of Management and Technology Lahore