Introduction: Pain in the upper back and neck is becoming increasingly common in the
modern world, and there are numerous factors that contribute to its onset, including age,
female gender, lower back pain, sedentary lifestyle, vibrations, headaches, emotional
problems, and low job satisfaction. The diaphragm is the main respiratory muscle and is also
crucial for postural stability. Through the transversalis and thoracolumbar fasciae, it is
anatomically connected to the cervical spine. Its reduced function can be a factor in the
development of upper back and neck pain. Objective: The purpose of this thesis is to analyse
the effects of manual diaphragmatic relaxation in subjects with pain in the upper back and
neck based on a literature review. Methods: The literature search was conducted in
electronic databases including PubMed, PEDro, Cochrane Library, and Google Scholar.
Results: After reviewing inclusion and exclusion criteria, six studies were included. Authors
used various measurement tools to assess craniovertebral angle, chest expansion,
diaphragmatic movement, pain, and active range of motion of the cervical spine. A
significant effect on reducing the craniovertebral angle and, therefore, anterior head
positioning, chest expansion, and increased diaphragmatic movement was observed. A
significant effect on reducing pain was only found in one study. No significant effect on
increasing active range of motion of the cervical spine was confirmed. Discussion and
Conclusion: Based on the literature review, it can be concluded that manual diaphragmatic
relaxation is an effective technique for reducing the craniovertebral angle, increasing chest
expansion, and improving diaphragmatic movement. Further research on a larger sample of
subjects, examining the long-term effects of this approach, would be necessary to confirm
these results.
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