The within-group analysis using Friedman’s Test indicated statistically significant improvements in pain intensity and functional disability across all time points for both groups (p < 0.000).

Background: Chronic neck pain (CNP) is a prevalent condition affecting up to 50% of office workers annually. Cervicogenic headache (CEH) is a headache type originating from cervical spine dysfunction.Objective: This study aimed to compare the effects of spinal manipulation and conventional massage therapy on pain intensity, range of motion, and functional disability in patients with CNP, with or without CEH.Methods: A randomized clinical trial was conducted at four hospitals in Lahore, Pakistan. Seventy-eight patients aged 20-40 years were enrolled using a non-probability convenient sampling technique. Patients were randomized into two groups: Group A received spinal manipulation, and Group B received conventional massage therapy, both combined with electrotherapy and neck exercises for six weeks. Pain intensity and disability were measured using the Numerical Pain Rating Scale (NPRS) and Neck Disability Index (NDI) at baseline, three weeks, and six weeks. Data were analyzed using SPSS 25.Results: Significant reductions in NPRS and NDI scores were observed in Group A compared to Group B at the third week (p = 0.001) and sixth week (p < 0.000).Conclusion: Spinal manipulation was more effective than conventional massage therapy in reducing pain and improving function in patients with CNP, with or without CEH.