BACKGROUND: Although guidelines and systematic reviews recommend the use of exercise in the treatment of chronic pain and neck pain, there are no clear recommendations for conservative treatments frequently used in clinics. The effect of supporting clinical Pilates exercises with passive physiotherapy methods on biopsychosocial status is still unknown. OBJECTIVES: The objective was to investigate the effects of conventional treatment (CT) in addition to clinical Pilates on pain levels, physical condition, functional status, and psychosocial status in individuals with chronic neck pain. METHODS: Fifty women were randomly divided into 2 groups, the clinical Pilates group (Pilates, n = 25), and the group receiving CT in addition to clinical Pilates (Pilates-CT, n = 25). Both groups received treatment 3 days a week for 6 weeks. The CT program involved the implementation of hot pack (HP) application, Transcutaneous Electrical Nerve Stimulation (TENS), and therapeutic ultrasound (US) to the cervical area. RESULTS: CT in addition to Pilates was more effective in reducing the Visual Analog Scale (at rest and during activity), Neck Disability Index, Fear-Avoidance Beliefs Questionnaire, NeckPix Scale, Hospital Anxiety and Depression Scale-depression, and Cognitive Exercise Therapy Approach-Biopsychosocial questionnaire scores (p < 0.05) and in increasing the degree of change in the extension range of motion (ROM) and cervical flexor endurance values and scores in the energy parameter of Short Form-36 (p < 0.05). CONCLUSIONS: CT provided in addition to Pilates was more effective in reducing pain levels, disability, fear of movement, depression levels, and negative biopsychosocial status and improving extension ROM and cervical flexor endurance, neck awareness, and the energy/vitality parameter of quality of life in individuals with chronic neck pain.

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