Muscle energy technique to reduce pain and disability in cases of non-specific neck pain: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND: To investigate the effectiveness of muscle energy technique (MET) for treatment of non-specific neck pain (NSNP). METHODS: A literature search was performed using electronic databases from their inception until October 2023 for randomized controlled trials (RCTs) that investigated the effects of MET on NSNP. A change in pain intensity and reduced disability were the primary and secondary outcomes, respectively, standardized using Hedges’ g. A random effects model was used for data pooling. RESULTS: This study included 26 RCTs comprising 1170 participants. The results showed that MET significantly reduced pain intensity (Hedges' g = −0.967 95 % CI = −1.417 to −0.517, p < 0.001). However, subgroup analysis revealed that this significant benefit was observed only when MET was combined with other treatments and not with MET monotherapy. MET also reduced disability (Hedges’ g = −0.545, 95 % CI = −1.015 to − 0.076, p = 0.023). Meta-regression analysis showed that an increase in treatment duration/session per week contributed to greater pain reduction. No adverse events were reported following the MET. CONCLUSIONS: In conclusion, our meta-analysis suggests MET's potential effectiveness within a combined treatment for NSNP. However, the evidence's low certainty is likely influenced by bias and study variations. To strengthen these findings, future research should focus on higher-quality clinical trials, longer follow-up periods, and prediction interval presentations.