Comparative Effects of Myofascial Release and Bowen Therapy in Patients with Text Neck Syndrome

Abstract

Introduction The phrase ‘text neck’ refers to an overuse syndrome or repetitive stress injury caused by a person bending down and keeping their head hanging or curved forward while staring at a smartphone or other electronic device for extended periods.

Methods In a randomised clinical trial study conducted at the University of Lahore Teaching Hospital, 30 patients (18–35 years old, both sexes) with text neck syndrome and chronic neck pain were divided into two groups: group A (myofascial release therapy, n = 15) and group B (Bowen therapy, n = 15). Both groups received their respective therapies and conventional physical therapy (hot pack) for six weeks, three sessions per week. Assessments were made at baseline and after six weeks using the numeric pain rating scale (NPRS), neck disability index (NDI), craniovertebral angle (CVA), rounded shoulder assessment (RSA), and cervical range of motion (ROM), with data analysed using SPSS.

Results The study included two groups: A (mean age 27.27 ± 4.22 years) and B (mean age 28.73 ± 4.53 years). Group A showed a significant decrease in NPRS, craniovertebral angle, and rounded shoulder assessment post-treatment (p = 0.022). Group B showed significant decreases in NPRS and NDI scores post-treatment (p = 0.000).

Conclusions Results showed that both therapies were effective for patients with text neck syndrome. However, Bowen therapy reduces pain, improves cervical range of motion, and enhances well-being compared to the myofascial release group. Key words: neck pain, posture, pain management, musculoskeletal manipulation.

Discussion

The results of the current study show the two study groups – the myofascial release group and the Bowen therapy group – each consisting of 15 participants, making a total of 30 individuals. Group A consisted of 15 participants with a mean age of 27.26 and a standard deviation of 4.21 years, while group B was made up of 15 participants with a mean age of 28.73 and a standard deviation of 4.52 years. The sex distribution across both groups comprises 33.3% males and 66.7% females. According to the paired differences, the analysis within the myofascial release group indicates a significant decrease in NPRS scores but no significant change in NDI scores. In contrast, the Bowen therapy group shows significant reductions in both NPRS and NDI scores from pre- to post-treatment (0.000).

The study aimed to assess the impact of the myofascial release technique with and without Bowen therapy on persons with text neck syndrome. The study concentrated on assessing pain levels with the NPRS, functional status with the NDI, cervical ROM, and posture. The results of the repeated measures within-group ANOVA analysis showed that individuals who received the Myofascial Release Technique (MRT) saw a substantial improvement in cervical ROM, posture, and a notable decrease in discomfort, with a p-value below 0.05 [14]. The findings align with a previous study, suggesting that post-isometric relaxation can increase range of motion, reduce pain levels, and raise NDI scores in patients with non-specific neck discomfort, irrespective of the inclusion of stretching [15].

A similar study comparing home-based massage therapy and hot pack therapy for neck and shoulder pain found significant improvements in pain relief, cervical ROM, and functional disability, reinforcing the importance of combining thermal modalities with manual interventions [16].

A further study confirmed these results, emphasising the beneficial impact of the Bowen approach on cervical ROM, improved neck function, and reduced discomfort. The study found a direct correlation between smaller craniovertebral angles and a more pronounced forward head position (FHP), which is associated with higher levels of impairment. Both groups showed notable improvements in posture, decreases in the forward shoulder angle, and increases in craniovertebral angles. The study suggests that using Bowen therapy and MRTs together may offer advantages for persons with text neck syndrome [17].

This study reports the findings of a randomised controlled trial that confirms the efficacy of Bowen therapy in treating myofascial neck pain in patients. The results indicate that ISBT- Bowen Therapy led to increased Pressure Pain Threshold (PPT), enhanced cervical ROM, decreased pain levels, improved occupational functioning, elevated mood, and an overall better quality of life compared to conventional therapy. The benefits of Bowen therapy were observed to persist for at least 12 weeks after the treatment course ended. Furthermore, the study highlights the sustained improvement in PPT, a measure of pain sensitivity and intensity in deep muscle tissues, following Bowen therapy [18]. Bowen therapy not only reduces current pain but also aids in mending the fascia, supporting continuous rehabilitation and improving performance in daily activities. Bowen therapy seems to offer more enduring benefits compared to dry needling and trigger-point injections. The study highlights the positive impact of Bowen therapy on muscular flexibility and cervical range of motion (CROM), showing notable enhancements in many directions, except for neck extension in individuals experiencing severe neck discomfort [19].

A new randomised controlled study investigated the impact of Bowen therapy on text neck discomfort in young adults, revealing noteworthy results. During a two-week therapy period, Bowen therapy significantly reduced both the severity and occurrence of headaches. Text neck discomfort has numerous common causes, including poor sleep patterns, incorrect body posture, exhaustion, and increased stress levels, resulting in a feeling of pressure around the head [20]. Studies show that Bowen therapy is successful in reducing muscle tension, leading to a significant decrease in the intensity of headaches. Participants receiving Bowen therapy experienced a significant decrease in pain severity after attending six sessions over a two-week period. The results are consistent with previous studies highlighting the effectiveness of Bowen therapy in alleviating pain for those experiencing musculoskeletal issues. Bowen therapy was found to reduce sympathetic activity and improve parasympathetic response in the autonomic nervous system. This is consistent with prior research suggesting heightened parasympathetic activity in the regulation of chronic pain, possibly through involvement of the periaqueductal grey and descending inhibitory circuits [21].

This study investigated the impact of Bowen therapy on neck discomfort in patients, namely caused by bad posture, and found that the therapy was as effective as traditional approaches. The treatment successfully decreased discomfort, increased cervical range of motion, adjusted the craniovertebral angle, and improved overall functionality. The statistical analysis showed no significant difference in pain levels between the experimental and control groups, since the p-value was greater than 0.05 [22]. Within the Bowen technique group, a notable reduction in pain levels (p < 0.05) was noted one week after the session.

The temporary relief from Bowen therapy consistently improved cervical rotation, and NDI, Numerical Pain Rating Scale (NPRS), and Bowen technique scores for all participants, with statistically significant results (p < 0.05) [23, 24].

Read the full paper HERE