# An Integrated Cervical Stabilization Exercise and Thai Self-Massage Approach for Managing Chronic Nonspecific Neck Pain in Young Adults: A Single-Blind Randomized Controlled Trial

## TL;DR

A self-care program combining cervical exercises and Thai self-massage reduced neck pain and disability in young adults with chronic nonspecific neck pain.

## Contribution

This study introduces a novel integrative self-care approach combining cervical stabilization exercises and Thai self-massage for managing chronic neck pain.

## Key findings

- The CSTM group showed greater reductions in pain intensity and neck disability compared to the control group.
- Improvements were maintained at a two-week follow-up after the four-week intervention.
- Both groups experienced significant improvements in pain and disability, but CSTM was more effective.

## Abstract

Public health relevance—how does this work relate to a public health issue?
Chronic nonspecific neck pain represents a growing public health burden, particularly among young adults, contributing to reduced productivity, functional limitation, and early healthcare utilization.Scalable self-care interventions are increasingly important to address musculoskeletal pain in community and home settings where access to long-term supervised care is limited.

Chronic nonspecific neck pain represents a growing public health burden, particularly among young adults, contributing to reduced productivity, functional limitation, and early healthcare utilization.

Scalable self-care interventions are increasingly important to address musculoskeletal pain in community and home settings where access to long-term supervised care is limited.

Public health significance—why is this work of significance to public health?
This randomized controlled trial demonstrates that an integrative self-care program combining cervical stabilization exercises and Thai self-massage can reduce pain and disability in young adults with chronic nonspecific neck pain.The findings support the role of low-cost, non-pharmacological self-management strategies as part of population-level approaches to musculoskeletal health promotion.

This randomized controlled trial demonstrates that an integrative self-care program combining cervical stabilization exercises and Thai self-massage can reduce pain and disability in young adults with chronic nonspecific neck pain.

The findings support the role of low-cost, non-pharmacological self-management strategies as part of population-level approaches to musculoskeletal health promotion.

Public health implications—what are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Public health practitioners may consider incorporating structured exercise and self-massage programs into community-based musculoskeletal health initiatives targeting young adults.Policymakers and researchers should further evaluate the long-term effectiveness, adherence, and scalability of integrative self-care interventions across diverse and higher-risk populations.

Public health practitioners may consider incorporating structured exercise and self-massage programs into community-based musculoskeletal health initiatives targeting young adults.

Policymakers and researchers should further evaluate the long-term effectiveness, adherence, and scalability of integrative self-care interventions across diverse and higher-risk populations.

Background: Chronic nonspecific neck pain (CNNP) is a widespread musculoskeletal condition affecting individuals across all age groups. Although cervical stabilization exercises (CSE) and Thai self-massage have each demonstrated therapeutic potential, evidence regarding the effectiveness of the combined applications of CSE and Thai self-massage remains limited. This study aimed to investigate the effects of a combined program of CSE and Thai self-massage (CSTM) on pain intensity (PI), pressure pain threshold (PPT), and neck disability (ND) in young adults with CNNP. Methods: This single-blind randomized controlled trial was conducted at the Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Thailand. Fifty young adults with CNNP were randomly assigned into two groups. The CSTM group performed CSE integrated with Thai self-massage, whereas the control group practiced stretching exercises exclusively. Both groups engaged in their respective programs three times per week for a duration of four weeks. PI, PPT, and ND were assessed at baseline, after four weeks (Week 4), and at a two-week follow-up (Week 6). Results: Both groups showed significant improvements in PI, PPT, and ND (p < 0.05), representing within-group comparisons, at Week 4 and Week 6. Furthermore, between-group comparisons at Week 4 and Week 6 indicated that the CSTM group achieved significantly greater improvements in PI and ND than the control group (p < 0.05). Conclusion: A four-week program combining CSE with Thai self-massage was effective in reducing pain intensity and neck disability in young adults with CNNP, with benefits maintained at short-term follow-up. Trial registration: Thai Clinical Trials Registry (TCTR20231102008), registered on 2 November 2023.