Prognostic Factor Analysis for Management of Chronic Neck Pain : Can We Predict the Severity of Neck Pain with Lateral Cervical Curvature?

Seong, Han Yu,Lee, Moon Kyu,Jeon, Sang Ryong,Roh, Sung Woo,Rhim, Seung Chul,Park, Jin Hoon The Korean Neurosurgical Society 2017 Journal of Korean neurosurgical society Vol.60 No.4

Objective : Although little is known about its origins, neck pain may be related to several associated anatomical pathologies. We aimed to characterize the incidence and features of chronic neck pain and analyze the relationship between neck pain severity and its affecting factors. Methods : Between March 2012 and July 2013, we studied 216 patients with chronic neck pain. Initially, combined tramadol (37.5 mg) plus acetaminophen (325 mg) was administered orally twice daily (b.i.d.) to all patients over a 2-week period. After two weeks, patients were evaluated for neck pain during an outpatient clinic visit. If the numeric rating scale of the patient had not decreased to 5 or lower, a cervical medial branch block (MBB) was recommended after double-dosed previous medication trial. We classified all patients into two groups (mild vs. severe neck pain group), based on medication efficacy. Logistic regression tests were used to evaluate the factors associated with neck pain severity. Results : A total of 198 patients were included in the analyses, due to follow-up loss in 18 patients. While medication was successful in reducing pain in 68.2% patients with chronic neck pain, the remaining patients required cervical MBB. Lateral cervical curvature, such as a straight or sigmoid type curve, was found to be significantly associated with the severity of neck pain. Conclusion : We managed chronic neck pain with a simple pharmacological management protocol followed by MBB. We should keep in mind that it may be difficult to manage the patient with straight or sigmoid lateral curvature only with oral medication.

Relationship of neck disability index, shoulder pain and disability index, and visual analogue scale in individuals with chronic neck pain

Hwang, Sujin,Mun, Mee-Hyang korean Academy of Physical Therapy Rehabilitation 2013 Physical therapy rehabilitation science Vol.2 No.2

Objective: Several muscles surrounding neck are vital not only for neck motion, but for upper extremities motions as well. Neck pain would affect neck and shoulder disability. The Neck Disability Index (NDI), Shoulder Pain and Disability Index (SPADI), and Visual Analogue Scale (VAS) are increasingly used to evaluate treatment effectiveness after chronic neck pain. The purpose of this study was to analyze the correlation of neck pain, shoulder pain, and quality of life in patients with chronic neck pain. Design: Cross-sectional study. Methods: Forty-three patients with neck pain participated in this study. Participants were instructed to place a mark on each item of three clinical measures that best represented their experience of his/her neck and shoulder problem over the last week. The outcome measures of the study were NDI, SPADI, and VAS for neck and shoulder pain and disability. Results: The NDI was significantly correlated with the VAS-Neck, SPADI-Pain, SPADI-Disability, SPADI-Total, and VAS-Shoulder (p<0.05). The VAS-Neck was significantly correlated with the VAS-Neck, SPADI-Pain, SPADI-Disability, SPADI-Total, and VAS-Shoulder (p<0.05). The SPADI-Total was significantly correlated with the NDI, VAS-Neck, SPADI-Pain, SPADI-Disability, and VAS-Shoulder (p<0.05). The SPADI-Pain was significantly correlated with the NDI, VAS-Neck, SPADI-Disability, SPADI-Total, and VAS-Shoulder (p<0.05). The SPADI-Disability was significantly correlated with the NDI, VAS-Neck, SPADI-Total, SPADI-Pain, and VAS-Shoulder (p<0.05). The VAS-Shoulder was significantly correlated with the NDI, VAS-Neck, SPADI-Pain, SPADI-Disability, and SPADI-Total (p<0.05). Conclusions: Neck disability in patients with chronic neck pain should be considered with disability and pain of the shoulder.

Original Article : Relationship of neck disability index, shoulder pain and disability index, and visual analogue scale in individuals with chronic neck pain

( Su Jin Hwang ),( Mee Hyang Mun ) 물리치료재활과학회 2013 Physical therapy rehabilitation science Vol.2 No.2

Objective: Several muscles surrounding neck are vital not only for neck motion, but for upper extremities motions as well. Neck pain would affect neck and shoulder disability. The Neck Disability Index (NDI), Shoulder Pain and Disability Index (SPADI), and Visual Analogue Scale (VAS) are increasingly used to evaluate treatment effectiveness after chronic neck pain. The purpose of this study was to analyze the correlation of neck pain, shoulder pain, and quality of life in patients with chronic neck pain. Design: Cross-sectional study. Methods: Forty-three patients with neck pain participated in this study. Participants were instructed to place a mark on each item of three clinical measures that best represented their experience of his/her neck and shoulder problem over the last week. The outcome measures of the study were NDI, SPADI, and VAS for neck and shoulder pain and disability. Results: The NDI was significantly correlated with the VAS-Neck, SPADI-Pain, SPADI-Disability, SPADI-Total, and VAS-Shoulder (p<0.05). The VAS-Neck was significantly correlated with the VAS-Neck, SPADI-Pain, SPADI-Disability, SPADI- Total, and VAS-Shoulder (p<0.05). The SPADI-Total was significantly correlated with the NDI, VAS-Neck, SPADI-Pain, SPADI- Disability, and VAS-Shoulder (p<0.05). The SPADI-Pain was significantly correlated with the NDI, VAS-Neck, SPADI- Disability, SPADI-Total, and VAS-Shoulder (p<0.05). The SPADI-Disability was significantly correlated with the NDI, VAS- Neck, SPADI-Total, SPADI-Pain, and VAS-Shoulder (p<0.05). The VAS-Shoulder was significantly correlated with the NDI, VAS-Neck, SPADI-Pain, SPADI-Disability, and SPADI-Total (p<0.05). Conclusions: Neck disability in patients with chronic neck pain should be considered with disability and pain of the shoulder.

An Analysis of Various Factors Affecting Neck Pain and Dysfunction in Adults with Chronic Neck Pain Using Regression Analysis

Seiyoun Park,Sangbin Lee 국제물리치료연구학회 2019 Journal of International Academy of Physical Ther Vol.10 No.4

Background: The prevalence of neck pain and neck dysfunction is high in general population. However, there is little literature on the relationship and factors affecting neck pain and neck dysfunction. Objective: To investigate the correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction, and sleep quality in adults with chronic neck pain, and factors affecting neck pain and neck dysfunction. Design: Cross-sectional study Methods : The sample included 114 subjects, who had complained of chronic neck pain for more 12 weeks. We conducted a Pearson’s correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction and sleep quality and a regression analysis of the related variables, thereby analyzing factors affecting neck pain and neck dysfunction. Results : In the present study, in adults with chronic neck pain, neck pain was positively correlated with the Neck Disability Index (NDI), Shoulder Pain and Disability Index (SPADI)-Pain score, and SPADI-Total score (p<.05). The NDI was positively correlated with neck pain, SPADI-Pain score, and SPADI-Total score, as well as with Pittsburgh Sleep Qulity Index(PSQI-K) (p<.05). Among the factors affecting neck pain, shoulder disability as assessed by the SPADI was a significantly associated with neck pain, while shoulder pain and shoulder disability determined by the SPADI were identified as significant variables among the factors affecting neck disability. Conclusion : These results indicated that as neck pain worsened , shoulder pain and neck and shoulder dysfunction also increased, which suggested that shoulder disability affected neck pain. In addition, as the neck dysfunction increased, neck pain and shoulder pain and shoulder dysfunction increased, and sleep quality deteriorated, which suggested that shoulder pain and shoulder disability affected neck disability.

Evaluation of the Association between Neck Pain and the Trapezius Muscles in Patients with Cervical Myelopathy Using Motor Evoked Potential: A Retrospective Study

Ito Sadayuki,Sakai Yoshihito,Harada Atsushi,Ando Kei,Kobayashi Kazuyoshi,Nakashima Hiroaki,Machino Masaaki,Kambara Shunsuke,Inoue Taro,Hida Tetsuro,Ito Kenyu,Ishiguro Naoki,Imagama Shiro 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.5

Study Design: Retrospective study. Purpose: We aimed to use motor evoked potentials (MEPs) to examine the association of electrophysiological assessment of the trapezius muscle with neck pain. Overview of Literature: Previous reports on the association of neck pain with the trapezius muscle have focused on surface electromyograms and muscle oxygenation; however, to our knowledge, none of these studies included detailed data on MEPs. Methods: The study included 100 patients with cervical myelopathy who underwent surgery at the National Center for Geriatrics and Gerontology in Obu, Japan from June 2010 to March 2013. Before the surgery, neck pain was evaluated using a Visual Analog Scale (a score ≥50 indicated neck pain and a score <50 indicated no neck pain). The preoperative cross-sectional areas of the trapezius muscles were measured with cervical magnetic resonance imaging sagittal T2-weighted images. Cranial stimulation under general anesthesia was used to derive the MEPs, enabling the measurement of latency and amplitude, using preoperative MEPs of the trapezius muscles. Results: The MEP of the trapezius muscle in patients with neck pain had significantly shorter latencies than those in patients who did not have neck pain. However, there was no significant difference in the amplitude between patients with and without neck pain. However, this tended to be greater in patients with neck pain as compared to that in those without neck pain. The cross-sectional area of the trapezius muscle in patients with neck pain was significantly smaller than that in those who did not have neck pain. Conclusions: MEPs revealed electrophysiological abnormalities of the trapezius muscles in patients with neck pain, supporting a relationship of neck pain with the trapezius muscles.

The Strength of the Lower Trapezius in Violinists With Unilateral Neck Pain

Si-hyun Kim,Kyue-nam Park 한국전문물리치료학회 2014 한국전문물리치료학회지 Vol.21 No.4

Violinists tend to position the neck asymmetrically to hold the violin between the chin and the left shoulder. Asymmetrical neck posture may induce unilateral neck pain. Previous studies have suggested that individuals with unilateral neck pain exhibit reduced muscle strength of the lower trapezius, but no study has investigated violinists with unilateral neck pain. To this end, we recruited 18 violinists with unilateral neck pain for the present study in which the side on which neck pain was experienced, pain duration, and intensity were recorded. Lower trapezius strength was measured bilaterally in each subject using a handheld dynamometer. Significant differences in lower trapezius strength were evident between the ipsilateral and contralateral sides of neck pain (p<.05). No significant association between neck pain intensity or duration, and the extent of a deficit in lower trapezius strength, was evident (both p>.05). The association between the sides of weakened lower trapezius strength and neck pain was significant (p<.05). In conclusion, violinists with unilateral neck pain exhibited significantly less lower trapezius strength on the ipsilateral compared to the contralateral side of the pain. Unilateral neck pain more frequently involved the left side of the neck, which is used to stabilize the violin during playing. Thus, our study suggests that a possible relationship exists between muscle weakness in the lower trapezius and neck pain.

Prevalence and Risk Factor of Neck Pain in Elderly Korean Community Residents

Son, Kyeong Min,Cho, Nam H.,Lim, Seung Hun,Kim, Hyun Ah The Korean Academy of Medical Sciences 2013 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.28 No.5

<P>Neck pain is a common musculoskeletal condition, which causes substantial medical cost. In Korea, prevalence of neck pain in community based population, especially in elderly subjects, has scarcely been reported. We evaluated the prevalence, the severity and the risk factors of neck pain in elderly Korean community residents. Data for neck pain were collected for 1,655 subjects from a rural farming community. The point, 6-months and cumulative lifetime prevalence of neck pain was obtained in addition to the measurement of the severity of neck pain. The mean age of the study subjects was 61 yr and 57% were females. The lifetime prevalence of neck pain was 20.8% with women having a higher prevalence. The prevalence did not increase with age, and the majority of individuals had low-intensity/low-disability pain. Subjects with neck pain had a significantly worse SF-12 score in all domains except for mental health. The prevalence of neck pain was significantly associated with female gender, obesity and smoking. This is the first large-scale Korean study estimating the prevalence of neck pain in elderly population. Although the majority of individuals had low-intensity/low-disability pain, subjects with neck pain had a significantly worse SF-12 score indicating that neck pain has significant health impact.</P>

Prevalence and Risk Factor of Neck Pain in Elderly Korean Community Residents

손경민,Nam H. Cho,이승헌,김현아 대한의학회 2013 Journal of Korean medical science Vol.28 No.5

Neck pain is a common musculoskeletal condition, which causes substantial medical cost. In Korea, prevalence of neck pain in community based population, especially in elderly subjects, has scarcely been reported. We evaluated the prevalence, the severity and the risk factors of neck pain in elderly Korean community residents. Data for neck pain were collected for 1,655 subjects from a rural farming community. The point, 6-months and cumulative lifetime prevalence of neck pain was obtained in addition to the measurement of the severity of neck pain. The mean age of the study subjects was 61 yr and 57% were females. The lifetime prevalence of neck pain was 20.8% with women having a higher prevalence. The prevalence did not increase with age, and the majority of individuals had low-intensity/low-disability pain. Subjects with neck pain had a significantly worse SF-12score in all domains except for mental health. The prevalence of neck pain was significantly associated with female gender, obesity and smoking. This is the first large-scale Korean study estimating the prevalence of neck pain in elderly population. Although the majority of individuals had low-intensity/low-disability pain, subjects with neck pain had a significantly worse SF-12 score indicating that neck pain has significant health impact.

경부통증 환자의 변형된 운동조절 특성 분석과 향후 활용 방안

이민영(Min-young Lee),윤범철(Bum-chul Yoon) 한국전문물리치료학회 2016 한국전문물리치료학회지 Vol.23 No.2

Background: It is necessary to find and develop the effective way of intervention for patients with neck pain, since the neck pain is becoming increasingly common throughout the world. To identify the altered motor control in patient with neck pain would be informative to find and develop the effective way of intervention. Objects: The aim of this study was to review literature regarding the altered motor control in patients with neck pain, measured by using surface electromyography (sEMG), ultrasonography, and functional magnetic resonance imaging (fMRI), and to suggest prospective research work on neck pain. Methods: Case-control (neck pain/healthy) studies published between 2004 and 2015 that investigated neck muscle activation, thickness, cross-sectional area, and fat infiltrate were searched in Scopus, PubMed, and ScienceDirect. Twenty-eight articles were included in this study. Results: sEMG, ultrasonography, and fMRI were used complementarily to investigate the altered superficial and deep neck muscle activation, thickness, cross-sectional area, and fat infiltrate in patients with neck pain. They showed the following altered motor control when compared retrospectively with healthy subjects or during specific functional tasks: (1) increased superficial muscle activation, (2) lesser deep muscle thickness, (3) smaller cross-sectional area of the deep muscle, and (4) greater fat infiltrate in deep muscles. In particular, among the women, the office workers showed higher muscle activation of superficial neck muscles during functional tasks, although they did not have neck pain, than those who were not office workers. Conclusion: Studies revealed that patients with neck pain showed an altered motor control when compared with healthy subjects by using various assessment modalities. Understanding this phenomenon would help researchers design an effective intervention for alleviating neck pain or to evaluate the effectiveness of the intervention. In addition, we recommend that female office workers take measures to care for their necks before developing neck pain

사무직 근로자들에게 나타나는 직업 관련 목 통증에 관한 직장 내 스트레스와 작업자세의 전향적 조사

전덕훈 대한고유수용성신경근촉진법학회 2019 PNF and Movement Vol.17 No.2

Purpose: The purpose of this study was to identify the causal relationship between workplace stress and working posture and the development of work-related neck pain in office workers. Methods: The study participants included 62 office workers who had not experienced neck pain in the previous 12 months. A battery of measures to evaluate potential workplace risk factors in an office setting were conducted at baseline, and the 12-month incidence of work-related neck pain was reported via monthly questionnaires. Survival analysis was used to evaluate the longitudinal relationship between the workplace risk factors and the development of work-related neck pain. Results: The incidence of work-related neck pain was 1.91 (95% CI: 1.06–3.45) per 100 person months. The incidence of neck pain was predicted to be less likely to happen when workers had a more upright thorax posture during computer work (hazard ratio, 0.94; 95% CI: 0.89–0.99). However, stress may deteriorate the preventative effects of other risk factors on neck pain and showed a positive relationship with episodes of neck pain (hazard ratio, 1.37; 95% CI: 1.03–1.84). Conclusion: Understanding the psychophysiological effects of neck pain may explain the development of neck pain in office workers. Our interest in prevention plans and treatments should therefore involve a multifactorial pathology of neck pain in the workplace.