BACKGROUND: The sternocleidomastoid fascia (SCMF), with its rich innervation, may serve as a generator of pain for patients with chronic neck pain when it undergoes structural and biomechanical abnormalities. Myofascial technique (MFT) is commonly used to reduce tissue stiffness and pain. However, the evidence for these clinical benefits is limited. OBJECTIVE: To evaluate the immediate effects of standardized MFT compared to sham MFT on stiffness of sternocleidomastoid muscle, thickness of SCMF, pain intensity, and craniovertebral angle. METHOD: A randomized placebo-controlled trial conducted in November-December 2023. Forty-eight chronic nonspecific neck pain (CNNP) patients were randomized to standard MFT or sham MFT. Outcome measures were collected before intervention (T0) and immediately after intervention (T1). Pain intensity was also assessed on day 2 (T2). RESULTS: Compared with sham, MFT significantly reduced SCMF thickness bilaterally at rest (left: mean differences (MD) -0.03 cm, 95% confidence interval (CI) -0.05 to -0.02; right: MD -0.03 cm, 95% CI -0.04 to -0.01) and extension (left: MD -0.05 cm, 95% CI -0.06 to -0.03; right: MD -0.04 cm, 95% CI -0.14 to -0.01). MFT led to greater reductions in pain intensity at T1 (MD -0.83, 95% CI -1.41 to -0.25; p = 0.006) and T2 (MD -0.63, 95% CI -1.08 to -0.17; p = 0.009), with more participants achieving meaningful pain relief at both timepoints (T1: 58.3% versus 25.0%; T2: 29.2% versus 4.2%; both p < 0.0001). CONCLUSION: In patients with CNNP, MFT provided immediate pain relief concomitant with a reduction in SCMF thickness, providing objective support for its evidence-based use in physiotherapy.

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