BACKGROUND: Mulligan sustained natural apophyseal glide (SNAG) is a mobilization technique that aims to reduce pain and improve function by correcting positional errors in the facet joint. PURPOSE: To investigate the immediate effects of the Mulligan SNAG application on muscle stiffness, pain, pressure pain threshold (PPT) and range of motion (RoM) in patients with chronic mechanical neck pain. METHODS: A randomized, double-blind trial was conducted. Forty individuals with chronic mechanical neck pain (mean age 39.35 +/- 6.68 years) were randomized into two groups: Mobilization with movement group (MWMG), and sham group (SG). Muscle stiffness was measured with MyotonPro, pain intensity with Numerical Pain Rating Scale, cervical RoM with a digital inclinometer, and PPT with an algometer. Measurements were performed pre-and 5 minutes post-intervention in a single session. RESULTS: Muscle stiffness significantly changed in the MWMG for the left trapezius and right cervical extensors (p = 0.003, effect size (ES) 0.42; p = 0.031, ES 0.49, respectively), whereas no significant changes were observed in the SG (p = 0.097, ES 0.12; p = 0.270, ES 0.22, respectively). The MWMG showed improvements in pain (p = 0.001, ES 0.70) and RoM (right: p = 0.0001, ES 0.89; left: p = 0.0001, ES 0.99). The SG also showed improvements in pain (p = 0.0001, ES 0.76) and RoM (right: p = 0.0001, ES 0.49; left: p = 0.0001, ES 0.35). PPT improvements were observed in the MWMG for right and left trapezius (p = 0.0001, ES 1.21; p = 0.040, ES 0.43, respectively), whereas no significant changes occurred in the SG (p = 0.713, ES 0.03; p = 0.839, ES 0.01, respectively). CONCLUSION: The mobilization with movement technique leads to significant immediate improvements in muscle stiffness and pain-related parameters in individuals with chronic neck pain.

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