TENS Versus Ultrasound With Exercise for Mechanical Neck Pain.

July 21, 2026 updated by: BUSHRA NASEEM, Dow University of Health Sciences

Therapeutic Benefit of Two Modalities TENS and Ultrasound Along With Exercises in the Management of Mechanical Neck Pain; A Randomized Clinical Trial

This randomized clinical trial aims to compare the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) and therapeutic ultrasound, both combined with therapeutic exercises, in the management of mechanical neck pain.

A total of 44 participants male and female both with mechanical neck pain will be randomly allocated into two equal groups at the physiotherapy OPD of DOW Institute of Physical Medicine & Rehabilitation, Dow University of Health Sciences, Karachi. Group A will receive TENS with exercise, while group B will receive ultrasound with the same exercise protocol.

Both groups will receive 9 treatment sessions over 2 weeks. Outcomes will include pain intensity, functional disability, and cervical range of motion, assessed before and after the intervention.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Mechanical Neck Pain is described as immediate or prolonged discomfort in cervical and shoulder regions, starting from the base of skull to the spine of scapula, this discomfort may extend down the arms and leading to reduction in the range of motion in the neck region and it occurred without any prior history of trauma, infection or systematic issues like fractures. Nonspecific neck pain is because of postural and mechanical reasons also known as Mechanical Neck Pain. Neck problems are not dangerous but these issues may cause discomfort and firmness. Much of the time neck pain is because of poor posture and flawed ergonomics at work area. Across various countries including Pakistan, Australia, the USA (New York), China, Brazil, and Central Saudi Arabia studies have identified neck pain prevalence among medical students ranging from 8.23% to 65%. Neck pain prevalence most commonly increases with age and greater among women as compared to men. According to studies 30%, 43% men and women respectively once in their lifetime experience neck pain, out of them10% men and 17% women experience chronic pain. Studies reported the 2nd most common musculoskeletal cause of disability globally. It is estimated that there are approximately 12 cases of Mechanical Neck Pain (MNP) per 1000 individuals seeking medical attention per year. Neck pain is a most frequent reason to seek medical attention from healthcare providers. Across the general population, neck pain affects 14% to 71% adults at various stages in their lives, among north Europeans 1-year greater prevalence as compared to Asian population. In general, worldwide population, 25% women and 16% men in Sweden experience neck pain annually. Iran reported 15% prevalence of neck pain in adults. While the exact cause of neck pain remains unclear, it is widely recognized as having a miscellaneous origin. Research indicates a strong correlation with factors such as depression, anxiety, migraines, sedentary lifestyle, disrupted sleep patterns, and smoking. The rising interest in neck pain because of its global prevalence which is 4.9%. Neck pain holds the 4th positions among condition causing disability when assessed in terms of years lived with some sort of pain and disability. Neck pain is responsible for causing disabilities of various severities and major cause of substantial medical expenses, productivity losses and economic burden.

Methodology:

Participants who are diagnose and referred to the Physiotherapy Outpatient Department (OPD) of the DOW Institute of Physical Medicine & Rehabilitation at Dow University of Health Sciences, OJHA Campus, will be included in the study. All eligible participants will be thoroughly informed about the study through a structured Informed Consent Form. The researcher will introduce herself, explain the purpose, procedures, potential risks, and benefits of the study.

Participants will be allowed ample time to read the form, ask questions, and clarify any doubts. Those willing to participate will be asked to sign the consent form or provide a thumb impression. The screening and initial identification of eligible participants will be supervised by a senior physiotherapist. The informed consent process ensures compliance with ethical principles including autonomy, confidentiality, and the right to withdraw at any stage of the study without any penalty or impact on their ongoing care.

Sample size of 44 participants will be divided into two equal groups through simple random sampling technique through number generator table to ensure each participant has an equal chance of being selected and reduce selection biasness. The method used in the study comprise single blinded methodology.

Group A include 22 participants both male and females, will receive TENS (15 min), heating pad (10 min), followed by cervical active stretching (~4 min) and isometric exercises (~3 min), making a treatment subtotal of ~30 minutes, with the remaining time used for supervision, education, rest, and documentation (total 45 min/session).

Group B also include 22 participants, will receive therapeutic Ultrasound (10 min), heating pad (10 min), the same stretching (~4 min) and isometric exercises (~3 min), totaling ~27 minutes of treatment plus ~15 minutes for supervision and documentation (45 min/session).

Both groups will undergo 9 sessions over 2 weeks (6 consecutive sessions in week 1 and 3 alternate-day sessions in week 2).

Study Type

Interventional

Enrollment (Estimated)

44

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Pakistan
    • Sindh
      • Karachi, Sindh, Pakistan, 75300
        • Recruiting
        • Dow University of Health Sciences

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosed and referred patients with mechanical neck pain.
  • Participants with subacute or chronic neck pain.
  • Participants willing to participate in the study.
  • Participants with a Visual Analog Scale (VAS) pain score greater than 5 (moderate to severe pain).

Exclusion Criteria:

  • Participants with other musculoskeletal disorders, including rheumatoid arthritis, cervical spondylosis, spondylolisthesis, cervical radiculopathy, malignancy, or neurological disorders.
  • Participants with a history of trauma or whiplash injury.
  • Participants with chronic pain conditions such as fibromyalgia.
  • Participants with vertigo or dizziness.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: Group B (Ultrasound with Exercise)
Participants in this group will receive therapeutic ultrasound for 10 minutes, heating therapy for 10 minutes, followed by cervical active stretching and isometric exercises. Each session will last approximately 45 minutes. A total of 9 sessions will be provided over 2 weeks.
Device: Arm 1 Transcutaneous Electrical Nerve Stimulation (TENS) Therapeutic Exercise Heating Pad. Arm 2 Therapeutic Ultrasound Therapeutic Exercise Heating Pad

Participants will receive Transcutaneous Electrical Nerve Stimulation (TENS) for 15 minutes, heating therapy for 10 minutes, followed by cervical active stretching and isometric exercises during each treatment session. A total of 9 sessions will be conducted over 2 weeks.

Participants will receive therapeutic ultrasound for 10 minutes, heating therapy for 10 minutes, followed by cervical active stretching and isometric exercises during each treatment session. A total of 9 sessions will be conducted over 2 weeks.
Experimental: Group A (TENS with Exercise)
Participants will receive Transcutaneous Electrical Nerve Stimulation (TENS) for 15 minutes, heating therapy for 10 minutes, followed by cervical active stretching and isometric exercises. Each session will last approximately 45 minutes. A total of 9 sessions will be provided over 2 weeks.
Device: Arm 1 Transcutaneous Electrical Nerve Stimulation (TENS) Therapeutic Exercise Heating Pad. Arm 2 Therapeutic Ultrasound Therapeutic Exercise Heating Pad

Participants will receive Transcutaneous Electrical Nerve Stimulation (TENS) for 15 minutes, heating therapy for 10 minutes, followed by cervical active stretching and isometric exercises during each treatment session. A total of 9 sessions will be conducted over 2 weeks.

Participants will receive therapeutic ultrasound for 10 minutes, heating therapy for 10 minutes, followed by cervical active stretching and isometric exercises during each treatment session. A total of 9 sessions will be conducted over 2 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual Analog Scale (VAS) for Pain
Time Frame: Baseline and after 2 weeks of treatment.
Visual Analog Scale (VAS) for Pain: Scores range from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate worse pain.
Baseline and after 2 weeks of treatment.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Muscle strength measured using Manual Muscle Testing (MMT)
Time Frame: Baseline and after 2 weeks of treatment.
Manual Muscle Testing (MMT) grades muscle strength on a 0 to 5 scale, where 0 indicates no visible or palpable muscle contraction and 5 indicates normal muscle strength against full resistance. Higher scores indicate better muscle strength.
Baseline and after 2 weeks of treatment.
Pressure pain threshold measured using an algometer
Time Frame: Baseline and after 2 weeks of treatment.
Pressure Pain Threshold (PPT) is measured using an algometer and recorded in Newtons (N). The pressure pain threshold is the amount of force at which pressure first becomes painful. Higher values indicate a higher pressure pain threshold (better outcome/less pain sensitivity).
Baseline and after 2 weeks of treatment.
Neck disability measured using the Neck Disability Index (NDI)
Time Frame: Baseline and after 2 weeks of treatment.
The Neck Disability Index (NDI) scores range from 0 to 50, where higher scores indicate greater neck disability (worse outcome).
Baseline and after 2 weeks of treatment.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Dow University of Health Sciences

Investigators

  • Principal Investigator: Bushra naseem, DPT, MSAPT (In progress), DUHS

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

August 15, 2026

Primary Completion (Estimated)

September 15, 2026

Study Completion (Estimated)

September 15, 2026

Study Registration Dates

First Submitted

May 8, 2026

First Submitted That Met QC Criteria

July 21, 2026

First Posted (Actual)

July 23, 2026

Study Record Updates

Last Update Posted (Actual)

July 23, 2026

Last Update Submitted That Met QC Criteria

July 21, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IRB-4390/DUHS/Approval/2025/84

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared publicly due to confidentiality and ethical considerations. The data collected in this study will contain participant health information and will only be used for analysis and publication of study results by the Principal investigator. Access to the dataset will be restricted to ensure participant privacy and compliance with institutional ethical guidelines.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Mechanical Neck Pain

Clinical Trials on Arm 1 Transcutaneous Electrical Nerve Stimulation (TENS) Therapeutic Exercise Heating Pad. Arm 2 Therapeutic Ultrasound Therapeutic Exercise Heating Pad

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