Comparative Effects of Nerve Flossing and Deep Neck Flexor Muscle Strengthening on Pain, Range of Motion and Functional Disability on Cervical Spinal Stenosis (NF-DNF)

Cervical spinal stenosis is a condition characterized by narrowing of the spinal canal in the cervical region, leading to compression of neural structures. This often results in neck pain, reduced cervical range of motion, and functional disability that affects daily activities and quality of life. Conservative management through physiotherapy is the preferred initial approach before considering surgical intervention. Among conservative techniques, Nerve Flossing and Deep Neck Flexor strengthening are commonly used but their comparative effectiveness remains unclear. Nerve Flossing involves controlled, low-amplitude movements of the neck and upper limb to mobilize neural tissues and reduce nerve-related pain and sensitivity. Deep Neck Flexor strengthening uses specific low-load exercises to improve the activation and endurance of the deep cervical flexors that support head and neck posture. This study is conducted to address the gap in evidence by directly comparing these two interventions in patients with cervical spinal stenosis. The findings will help physiotherapists and clinicians select the most effective treatment approach for reducing pain and improving function in this population.