Multiregional Rehabilitation Targeting the Cervical and Temporomandibular Regions in Chronic Neck Pain: A Randomized Controlled Trial

Abstract

Background and Purpose Non-specific chronic neck pain (NSCNP) is highly prevalent and frequently associated with temporomandibular-related impairments, yet rehabilitation programs commonly focus on a single anatomical region. Given the functional and biomechanical interconnections between the cervical spine and temporomandibular region, this study aimed to compare the short-term effects of a cervical-focused rehabilitation program with an integrated cervical-temporomandibular rehabilitation approach in individuals with NSCNP.Methods In this single-blind, randomized controlled trial, 42 adults with NSCNP were allocated to receive either cervical rehabilitation alone (45 min/session) or an integrated cervical-temporomandibular rehabilitation program (60 min/session), delivered five sessions per week for 4 weeks. Primary outcomes were pain intensity (VAS) and neck-related disability (NDI). Secondary outcomes included posture, cervical range of motion, muscle endurance, and sleep quality. Outcomes were assessed at baseline and immediately post-intervention.Results Both groups demonstrated significant improvements in pain and disability following the intervention period (p < 0.001). Between-group analyses showed greater short-term reductions in pain intensity and neck-related disability in the integrated rehabilitation group compared with cervical rehabilitation alone, with large effect sizes. More pronounced improvements were also observed across several secondary outcomes, including posture, cervical mobility, muscle endurance, and sleep quality. No adverse events were reported.Discussion An integrated cervical-temporomandibular rehabilitation approach was associated with greater short-term clinical improvements under a higher overall treatment dose than cervical-focused rehabilitation alone in individuals with NSCNP. These findings suggest the potential clinical value of a multiregional treatment perspective; however, they should be interpreted with caution because the Cervical + TMJ group received a higher overall treatment dose, which precludes definitive attribution of the observed effects specifically to the temporomandibular-directed components. Additionally, the findings are limited to immediate post-intervention outcomes.Trial Registration This study is registered at ClinicalTrials.gov with ID: NCT06005922