MUSCLE DYSFUNCTION IN PEOPLE WITH NECK PAIN
12th November 2012
Many people suffer from neck pain at sometime in their life. Kari Niemi (Kinetic Control Accredited Tutor in Finland) has identifed some recent research projects illustrating examples of muscle dysfunction in people with neck pain patient and one follow-up-study regarding predictive factors of neck pain.
Delayed activation of:
- Serratus anterior activation and less duration of serratus anterior activity during unilateral arm elevation in scapular plane in patients with insidious onset of neck pain. No main effects or interaction for upper, middle and lower trapezius (surface EMG) (Helgadottir H et al 2011) - Deep cervical flexors during rapid shoulder flexion and extension in women with persistent neck pain. Muscle dysfunction was positively correlated with pain intensity not with disability, area of neck pain or duration of neck pain. (Falla D et al 2010)
Reduced activation of:
- Lower trapezius during typing task in patients with chronic neck pain. After scapular correction muscle activity was the same in the neck pain group compared to controls (Wegner S et al 2010) - Deep cervical flexors during CCF (Craniocervical flexion) in women with persistent neck pain. Muscle dysfunction was positively correlated with pain intensity not with disability, area of neck pain or duration of neck pain (Falla D et al 2010) - Longus colli and longus capitis bilaterally and in multiple levels during CCFT with induced right upper trapezius pain (Cagnie B et al 2011) - Semispinalis/multifidus bilaterally at level C7 to T1 during cervical extension exercise with induced upper trapezius pain (Cagnie B et al 2011) - Semispinalis cervicis in women with chronic trauma induced neck pain. Activation was also less defined (Schomacher J et al 2012)
Increased coactivation of:
- Splenius capitis and sternocleidomastoideus muscles during neck flexion, extension and circular contraction women with neck pain. Increased coactivation is associated with higher level of pain, perceived disability and reduced neck strength (Lindstrøm R et al 2011)
Increased activation of:
- Sternocleidomastoideus at left side at C6-7 level with induced right upper trapezius pain during CCFT . (Cagnie B et al 2011) - Splenius capitis at the left side at the level C2,C3 during cervical extension exercise with induced right upper trapezius pain - Middle trapezius in patients with chronic neck pain during typing task. After scapular correction muscle activity was the same in neck pain group compared to controls (Wegner S et al 2010)
- Significant differences in the appearance of Flexion Relaxation Phenomenom (FRP) of cervical extensors between women with chronic neck pain and controls. The FRP was observed in 85.7 % of healthy subjects and in 36.3 % of CNP patients. In either group there was no FRP observed in the upper trapezius (Maroufi N et al 2012) - In 6-year follow-up study neither neck strength or passive mobility of the cervical spine has predictive value for the later occurrence of neck pain in pain-free working age women (Salo P et al 2012)
Maroufi N, Ahmadi A, Mousavi Khatir SR 2012. A comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjects. Eur Spine J, (Epub ahead of print)
Helgadottir H, Kristjansson E. Einarsson E, Karduna A, Jonsson Jr. H 2011. Altered activity of serratus anterior during unilateral arm elevation in patients with cervical disorders. Journal of Electromyography and Kinesiology 21: 947–953
Falla D, O'Leary S, Farina D, Jull G 2011. Association between intensity of pain and impairment in onset and activation of the deep cervical flexors in patients with persistent neck pain. Clin J Pain. May;27(4):309-14
Lindstrøm R, Schomacher J, Farina D, Rechter L, Falla D 2011. Association between neck muscle coactivation, pain, and strength in women with neck pain. Manual Therapy 16:80-86.
Schomacher J, Dario Farina D, René Lindstroem R , Falla D 2012. Chronic trauma-induced neck pain impairs the neural control of the deep semispinalis cervicis muscle. Clinical neurophysiology123: 1403-1408.
Cagnie B, Dirks R, Schouten M, Parlevliet T, Cambier D, Danneels L 2011. Functional reorganization of cervical flexor activity because of induced muscle pain evaluated by muscle functional magnetic resonance imaging. Man Therapy. 2011 Oct;16(5):470-5
Salo P, Ylinen J, Kautiainen H, Häkkinen K, Häkkinen A 2012. Neck muscle strength and and mobility of the cervical spine as predictors of neck pain. Spine 37 : 1036 – 1040
Cagnie B, Shaun O’Leary S, James Elliott J, Peeters I 2011. Pain-induced changes in the activity of cervical extensor muscles evaluated by muscle functional magnetic resonance imaging. Clin J Pain 27: 392-397
Wegner S, Jull G, O`Leary S, Johnston V 2010. The effect of a scapular postural correction strategy on trapezius activity in patients with neck pain. Manual Therapy 15: 562-566