Chronic neck pain (CNP) is a common and disabling condition with an estimated prevalence of 10-20% especially women's. Although non-steroidal anti-inflammatory drugs, acetaminophen and muscle relaxants are effective in acute neck pain, they still lack sufficient proof regarding their long-term efficiency in CNP. Therefore, the results of the current study showed that low-dose amitriptyline is useful for the treatment of idiopathic CNP with high patients' satisfaction.

Amitriptyline shows significant efficacy towards several severe pain conditions. As the best optimal regimen for chronic neck pain (CNP) remains questionable, Amitriptyline was not examined for CNP. This study assessed the impact of bedtime Amitriptyline in managing CNP.

Two hundred and twenty participants randomised to either 5mg Amitriptyline or placebo group for two months. Patients received pill during the bedtime. Visual analogue scale (VAS) for pain was taken as analysis's primary endpoint. Hospital Anxiety and Depression Scale (HAD), Bergen Insomnia Score (BIS), and neck pain disability index (NPDI), before and at the end of two months of therapy, with the percentage of patient satisfaction evaluated at the end of follow-up only were considered as the secondary endpoints of the analysis. 

A total of 112 patients received Amitriptyline withdrew from the investigation due to intolerance. The Amitriptyline group exhibited significant lower VAS scores as compared to another group. Comparable notable improvements were noted with lesser extents for secondary outcome and percentage of patient satisfaction.

Low-dose Amitriptyline is useful in treating idiopathic CNP with fewer side effects and high patients' repayment.