BACKGROUND: Upper chest breathing patterns can increase accessory muscle activation and reduce cervical stability, contributing to neck pain. OBJECTIVE: To examine the effects of a respiratory exercise program on pain, cervical range of motion, disability, breathing patterns, and muscular endurance in patients with non-specific neck pain. DESIGN: randomized controlled trial. METHODS: Thirty-two patients with non-specific neck pain and upper chest breathing patterns were included. The study was conducted from July 19, 2021, to September 3, at a physical therapy center. Participants were randomly assigned to a breathing exercise (BE) or neck exercise (NE) group. Thermoelectric therapy, soft tissue relaxation, and thoracic spine mobilization were performed in both groups. The BE group performed breathing exercises, whereas the NE group performed general neck exercises. Pain intensity, neck disability index, cervical range of motion, breathing pattern, and deep cervical flexor endurance were measured before and after the intervention. Paired t-test and independent t-test compared pre- and post-test differences within and between groups. RESULTS: Both groups showed significant improvements in pain intensity and NDI (pain: BE versus NE mean difference 0.34, 95% CI -0.25 to 0.93, p = 0.239; NDI: 0.86, 95% CI -0.62 to 2.34, p = 0.249). Breathing pattern improved only in the BE group (mean difference 2.73, 95% CI 1.78 to 3.68, p < 0.0001). Endurance of deep cervical flexors increased in both groups, greater in NE (mean difference -15.98, 95% CI -25.26 to -6.70, p = 0.010). CONCLUSION: Breathing exercises improved breathing patterns in patients with non-specific neck pain, but effects on pain and disability were inconclusive.

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