Purpose <p>The objective of this study was to examine the impact of ergonomics training, exercise, and manual therapy program on neck pain, neck awareness, sleep quality, and fatigue severity in individuals employed in a textile factory.</p> Methods <p>Sixty textile factory workers aged 18–60 with neck pain were randomly assigned to an intervention group (n = 30) or control group (n = 30). The intervention group received ergonomic training, exercise, and manual therapy, while the control group received only ergonomic training. Outcomes—including neck pain (Bournemouth Neck Questionnaire), neck awareness (Fremantle Neck Awareness Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), and fatigue severity (Fatigue Severity Scale)—were measured at baseline (week 0) and post-intervention (week 12). The clinical study is registered under the following number: NCT06484569.</p> Results <p>A significant difference was observed in both groups in terms of neck pain, neck awareness, sleep quality, and fatigue severity variables. A subsequent comparison of the post-treatment values of the two groups revealed a significant discrepancy between all outcome measures. A substantial difference was identified between the intervention and control groups with regard to fatigue severity, neck awareness, sleep quality, and neck pain.</p> Conclusion <p>The combination of ergonomics training, manual therapy and therapeutic exercise may represent an effective strategy for the management of neck disorders in textile workers.</p>