Effect of Multimodal Physiotherapy on Sleep Quality and Architecture in Patients With Chronic Neck Pain With Sleep Disturbance: A Randomised Clinical Trial

Musculoskeletal Care. 2026 Sep;24(3):e70242. doi: 10.1002/msc.70242.

ABSTRACT

BACKGROUND: Chronic neck pain is frequently associated with disturbed sleep, yet evidence on physiotherapy's impact on objective sleep parameters remains limited. To our knowledge, this study is the first to evaluate the effects of exercises, interferential current therapy (IFT) and myofascial release therapy on sleep quality and polysomnographic parameters in this population.

METHODS: Thirty adult men with chronic neck pain and poor sleep were randomised (1:1) in a two-arm, assessor-blinded trial. Group 1 received therapeutic exercise plus interferential current therapy; Group 2 received the same plus myofascial release (MFR), 7 weeks. Outcomes included subjective sleep quality as a primary outcme, polysomnographic (PSG) architecture and pain as secondary outcomes.

RESULTS: Sleep quality improved significantly in both groups (time effect p < 0.001), with greater overall improvement in Group 2 (group effect p = 0.003). For PSG parameters, both groups improved. Compared with exercise + IFT, adding MFR produced greater changes in PSG N1% and REM% (Time × Group interaction), while other PSG parameters showed similar improvements across groups.

CONCLUSION: Physiotherapy significantly improved pain and sleep outcomes in patients with chronic neck pain. Exercise with IFT enhanced sleep continuity, while combining exercise with myofascial release further optimized sleep architecture, particularly N1% and REM%. These findings highlight the added value of multimodal physiotherapy for pain management and sleep improvement.

TRIAL REGISTRATION: This clinical trial was registered at the Clinical Trials Registry of India under the registration number CTRI/2019/09/021028.

PMID:42373586 | DOI:10.1002/msc.70242