McKenzie and ELDOA Comparison in Non-Specific Neck Pain Teachers

Neck pain, a common musculoskeletal condition and a common problem of the society, is "a pain originating from musculoskeletal tissue in the region from the Occiput to the First Thoracic Vertebrae". Approximately 2/3 of the population around Globe is affected by Neck Pain as it is the 4th leading cause of disability around the world. Several research has shown prevalence ranging between 14.2% to 71%, with increased frequency in females and middle-aged adults. Risk factors related to neck pain generally constitute trauma or sports related injuries, poor work environment and psychological issues. This common problem can further be categorized based on duration i.e. Acute (for less than 6 weeks), Sub Acute (for less than 3 months) and Chronic (For more than 3 months). Based on severity, it is further sub-divided into 3 categories (Mild, Moderate and Severe). Based on etiology it has 2 types, (Mechanical and Neuropathic) Non-Specific Neck pain (NNP), a broader term used, is a common appearance of Neck Pain elaborated as Pain without any defined cause. It can either be a Mechanical or a Postural complication. Non-Specific Neck pain can be diagnosed from the history of individual along with physical examination. Non-Specific Neck Pain responds to conservative management, but the recent Literature suggests that Exercise therapy is quite effective in treatment of Non-specific Neck Pain (NNP). Techniques include Exercise therapy, Manual therapy, Traction, Electrotherapeutic modalities, Stretching, Massage, Release Techniques (ARTs) which are effective not only for reducing Pain but also for improving Cervical Ranges and functional capacity of Individuals.

Teaching is considered among those Professions where Incidence of Neck pain is at its peak, a recent Literature suggest that Prevalence of Neck pain is 68.9% in teachers. Occupational Complications i.e. Long-standing hours, Faulty postures, Excessive use of electronic devices and Black boards are the major risk factors for teachers in developing Musculoskeletal Conditions, with an incidence of 40% to 95%.

McKenzie Protocol is an interventional approach used in the broader term of Exercise Therapy. A Literature published in International Journal of Physiotherapy and Research by researchers of Cairo University, Egypt showed that McKenzie Protocol is very effective for the treatment of Non-specific Spinal Pain. This technique encourages active patient involvement in decreasing pain which as a result increases the functional abilities of individuals. The Technique of Neck Retraction is very beneficial for increasing Cervical Ranges, improving Posture and relieving Neck pain. McKenzie Protocol is a very effective technique for preventing re-occurrence of Pain.

ELDOA an abbreviation used for a French acronym Elongation Longitudinaux avec Decoaption Osteo-Articulaire is a term described by Guy Voyer in 1979 as an active Traction technique used for stretching of Fascia and increasing Spacing of Spinal joints. Literature backs the claim that ELDOA is an effective technique used to decrease pain and increasing Muscle length. This technique release compression from the Facet joints which in return increase circulation and improves tone that helps in Pain reduction and Range improvement.

Neck Pain frequently affects teachers due to Occupational habits. According to the Global Burden of Disease (GBD) Study, neck pain is the second leading cause of years lived with disability (YLD) for adults, 50% - 75% of people do not recover from an acute episode and experience recurrent neck pain in the next 1 to 5 years. Approximately 68% of people develop persistent and chronic neck pain. A Meta-analysis focusing on the McKenzie Protocol indicated its efficacy in managing moderate to severe neck pain, relative to mild cases. Various studies have explored the individual effects of McKenzie and ELDOA techniques on Neck pain. However, no one has specifically investigated which protocol is more effective across different severity levels.

Inclusion criteria

• Normal BMI
• Neck Pain on NPRS (Mild 1-3, Moderate 4-6, Severe 7-10)
• Working Hour: At least 30 hrs. per week.
• Teaching Experience: More than 12 months

Exclusion criteria

• No Neurological Condition (+ve Spurling Test, +ve Compression test, +ve Distraction Test)
• No Other Musculoskeletal Condition. (Osteoporosis, Arthritis, TrPs)
• No Spinal Deformity. (Scoliosis, Forward Head)
• No Surgery (Spinal Surgery, Fracture)
• No Cervical Tumor
• No complaints about Dizziness, Migraine, Cervicogenic headache (+ve Flexion Rotation test)