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Query: UMLS:C0007859 (neck pain)
 3,931 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nine subjects with chronic mechanical neck pain syndromes were evaluated for pressure pain threshold (PPT) over standardized tender points in the paraspinal area surrounding a manipulable spinal lesion. The subjects were then allocated randomly to an intervention consisting of either an oscillatory mobilization of the cervical spine (n = 4), which was designated as the control procedure, or a rotational manipulation of the cervical spine (n = 5). An assessor-blinded re-evaluation of the pressure pain threshold levels was conducted after 5 min. In the group receiving a manipulation the mean increases in pressure pain threshold ranged from 40-56% with an average of 45%. In the control group no change in any of the pressure pain thresholds was found. These results were analyzed using ANOVA and were found to be statistically significant (p less than 0.0001). This study confirms that manipulation can increase local paraspinal pain threshold levels. The use of the pressure pain threshold meter allows for the determination of such a beneficial effect in the deeper tissues.
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PMID:Pressure pain threshold evaluation of the effect of spinal manipulation in the treatment of chronic neck pain: a pilot study. 232 55

This study evaluated whether addition of a cervical spine locking plate (CSLP) in two-level disc fusions improved the postoperative stability and reduced the time to healing. Radiostereometric analysis was used to obtain precise recordings of the three-dimensional motion between the fused vertebrae. Eighteen consecutive patients were operated on with excision of two adjacent cervical discs and anterior horseshoe grafting with autologous bone (Smith Robinson technique). Nine patients were randomized to stabilization with autologous bone grafting and CSLP plate fixation and nine patients to grafting without fixation. Clinical symptoms in terms of pain in the neck and the arm were analysed preoperatively and after 1 year using a visual analogue scale (VAS). The patients operated without a plate displayed increased rotations around the transverse axis, corresponding to the development of a kyphosis [mean value no plate/plate 14.4 degrees/0.8 degrees (repeated measure ANOVA: P < 0.01)]. The mean compression was 3.2 mm larger in patients operated without a plate (repeated measure ANOVA: P < 0.01). Patients operated without a plate had more arm pain at the 1-year follow up (P < 0.05, Mann-Whitney U test). The VAS score for neck pain did not differ significantly between the two groups. Plate fixation could not be demonstrated to increase the healing rate, promote more rapid fusion or influence the frequency of graft complications.
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PMID:Plate fixation adds stability to two-level anterior fusion in the cervical spine: a randomized study using radiostereometry. 976 38

Poor posture has been suggested as one of the main factors contributing to the high prevalence of neck pain in video display unit (VDU) users, but no clear association between pain and any particular resting neck posture has been found. Postural awareness of the neck, as indicated by the repositioning accuracy, may therefore be an appropriate measure and potentially useful assessment tool. The objective of this study is to examine whether posture and fatigue affect the head repositioning ability in typical VDU usage. A group of 20 healthy participants reproduced a normal comfortable posture for forward, upright and backward chair back inclinations in random order both before and after fatigue of the upper trapezius muscles. Ten repetitions of the posture were recorded for 2 s each, and the angular and translational deviations from the original head position were measured with regard to the external environment (head in space repositioning) and with regard to the trunk (head on trunk repositioning). Analysis by repeated measures ANOVA showed significant effects and interactions of fatigue and chair back inclination on the repositioning errors in the sagittal plane, which typically showed systematic trends towards certain postures rather than random errors around a mean position. While further work is required to examine the ergonomic impact of impaired repositioning ability, head repositioning is sensitive to ergonomic factors such as seating configuration and fatigue, and may therefore be a useful tool for evaluation of static working postures.
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PMID:The feasibility of repositioning ability as a tool for ergonomic evaluation: effects of chair back inclination and fatigue on head repositioning. 1680 Dec 32

Our aim was to examine the effects of a seated thoracic spine distraction thrust manipulation included in an electrotherapy/thermal program on pain, disability, and cervical range of motion in patients with acute neck pain. This randomized controlled trial included 45 patients (20 males, 25 females) between 23 and 44 years of age presenting with acute neck pain. Patients were randomly divided into 2 groups: an experimental group which received a thoracic manipulation, and a control group which did not receive the manipulative procedure. Both groups received an electrotherapy program consisting of 6 sessions of TENS (frequency 100Hz; 20min), superficial thermo-therapy (15min) and soft tissue massage. The experimental group also received a thoracic manipulation once a week for 3 consecutive weeks. Outcome measures included neck pain (numerical pain rate scale; NPRS), level of disability (Northwick Park Neck Pain Questionnaire; NPQ) and neck mobility. These outcomes were assessed at baseline and 1 week after discharge. A 2-way repeated-measures ANOVA with group as between-subject variable and time as within-subject variable was used. Patients receiving thoracic manipulation experienced greater reductions in both neck pain, with between-group difference of 2.3 (95% CI 2-2.7) points on a 11-NPRS, and perceived disability with between-group differences 8.5 (95% CI 7.2-9.8) points. Further, patients receiving thoracic manipulation experienced greater increases in all cervical motions with between-group differences of 10.6 degrees (95% CI 8.8-12.5 degrees) for flexion; 9.9 degrees (95% CI 8.1-11.7 degrees) for extension; 9.5 degrees (95% CI 7.6-11.4 degrees) for right lateral-flexion; 8 degrees (95% CI 6.2-9.8 degrees) for left lateral-flexion; 9.6 degrees (95% CI 7.7-11.6 degrees) for right rotation; and 8.4 degrees (95% CI 6.5-10.3 degrees) for left rotation. We found that the inclusion of a thoracic manipulation into an electrotherapy/thermal program was effective in reducing neck pain and disability, and in increasing active cervical mobility in patients with acute neck pain.
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PMID:Inclusion of thoracic spine thrust manipulation into an electro-therapy/thermal program for the management of patients with acute mechanical neck pain: a randomized clinical trial. 1869 28

The helical axis model can be used to describe translation and rotation of spine segments. The aim of this study was to investigate the cervical helical axis and its center of rotation during fast head movements (side rotation and flexion/extension) and ball catching in patients with non-specific neck pain or pain due to whiplash injury as compared with matched controls. The aim was also to investigate correlations with neck pain intensity. A finite helical axis model with a time-varying window was used. The intersection point of the axis during different movement conditions was calculated. A repeated-measures ANOVA model was used to investigate the cervical helical axis and its rotation center for consecutive levels of 15 degrees during head movement. Irregularities in axis movement were derived using a zero-crossing approach. In addition, head, arm and upper body range of motion and velocity were observed. A general increase of axis irregularity that correlated to pain intensity was observed in the whiplash group. The rotation center was superiorly displaced in the non-specific neck pain group during side rotation, with the same tendency for the whiplash group. During ball catching, an anterior displacement (and a tendency to an inferior displacement) of the center of rotation and slower and more restricted upper body movements implied a changed movement strategy in neck pain patients, possibly as an attempt to stabilize the cervical spine during head movement.
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PMID:Cervical helical axis characteristics and its center of rotation during active head and upper arm movements-comparisons of whiplash-associated disorders, non-specific neck pain and asymptomatic individuals. 1870 89

It has been demonstrated that patients receiving mobilization techniques do not exhibit tolerance to repeated applications. However, this phenomenon has not been investigated for thoracic manipulation. Our aim was to determine if patients receiving thoracic thrust manipulation exhibit tolerance to repeated applications in acute mechanical neck pain. Forty-five patients were randomly assigned to two groups. The control group received electro- and thermotherapy for 5 sessions, and the experimental group received the same program and also received a thoracic thrust manipulation once a week for 3 consecutive weeks. Outcome measures included neck pain and cervical mobility. Within-session change scores for pain and mobility during treatment sessions #1, 3, and 5 were examined with a one-way repeated measured ANOVA. A 2-way ANOVA with session as within-subject variable and group as between-subject variable was used to compare change scores for each visit between groups to ascertain if there were significant between-group differences in within-session changes for the experimental versus the control group. The ANOVA showed that for either group the 3 within-session change scores were not significantly different (P > 0.1). The 2-way ANOVA revealed significant differences between groups for both pain and neck mobility in within-session change scores (all, P < 0.001). Change scores in each session were superior in the experimental group as compared to those in the control group. The results suggest that patients receiving thoracic manipulation do not exhibit tolerance to repeated applications with regard to pain and mobility measures in acute mechanical neck pain. Further studies should investigate the dose-response relationship of thoracic thrust manipulation in this population.
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PMID:Repeated Applications of Thoracic Spine Thrust Manipulation do not Lead to Tolerance in Patients Presenting with Acute Mechanical Neck Pain: A Secondary Analysis. 2004 22

We sought to determine if simulated malingering trials of isometric cervical muscular strength in flexion, extension and right/left bending are substantially different from maximum effort trials in young, healthy subjects. A convenience sample of healthy, young adult subjects was used (M=9, F=9) who were free of neck pain. A uniaxial load cell was used to measure forces (N) produced by three trials of isometric flexion, extension and bilateral bending contractions of the head/neck muscles in two modes: comfortable maximum (MAX) and simulated (insincere) malingering (INSIN). An ANOVA model was created and tested post-hoc for paired differences within and between modes and genders. A separate ANOVA was conducted to test for differences in the ratio between flexion and extension (F/E ratio). In MAX mode, males were stronger in all ranges vs females; the expected F/E and bilateral ratios were demonstrated and good consistency of effort within and between trials was demonstrated by low CV's and high ICC's, respectively. In INSIN mode, all mean peak values were significantly lower in both genders; however, the difference between genders disappeared. Within-trial consistency was much poorer with significantly higher CV's while between-trial variability was good as demonstrated by high ICC's. The flexion/extension ratio was increased in INSIN vs MAX, with no difference between genders. It appears that simulated malingering trials produced consistent patterns of deviation from maximal effort trials: reduced peak values, increased flexion/extension ratio and increased variability of within-trial effort. These findings may provide a basis for valid indicators of insincere effort in neck pain patients.
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PMID:Simulated malingering in the testing of cervical muscle isometric strength. 2085 41

We developed a mental task with gaze direction recognition (GDR) by which subjects observed neck rotation of another individual from behind and attempted to recognize the direction of gaze. A randomized controlled trial was performed in test (n = 9) and control (n = 8) groups of subjects with chronic neck pain undergoing physical therapy either with or without the GDR task carried out over 12 sessions during a three-week period. Primary outcome measures were defined as the active range of motion and pain on rotation of the neck. Secondary outcome measures were reaction time (RT) and response accuracy in the GDR task group. ANOVA indicated a main effect for task session and group, and interaction of session. Post hoc testing showed that the GDR task group exhibited a significant simple main effect upon session, and significant sequential improvement of neck motion and relief of neck pain. Rapid effectiveness was significant in both groups. The GDR task group had a significant session-to-session reduction of RTs in correct responses. In conclusion, the GDR task we developed provides a promising rehabilitation measure for chronic neck pain.
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PMID:Effectiveness of the gaze direction recognition task for chronic neck pain and cervical range of motion: a randomized controlled pilot study. 2264 85

Neck muscle fatigue has been shown to alter an individual's balance in a similar way to that reported in subjects suffering from neck pain or subjects that have suffered a neck injury. The main purpose of the present study was to quantify the effects of neck fatigue on neck muscle electromyography (EMG) activity, balance, perceived fatigue and perceived stability. Forty four elite amateur rugby league players resisted with their neck muscles approximately 35% maximum voluntary isometric contraction (MVIC) force for 15 minutes in eight different directions. Sway velocity and surface electromyography were measured. Questionnaires were used to record perceived effort and stability. Repeated measures ANOVA showed that after 15 minutes isometric contraction, significant changes were seen in sway velocity, perceived sway and EMG median frequency. There were no differences in perceived efforts. The changes in sway velocity and median frequency were more pronounced after extension and right and left posterior oblique contractions but there was no significant difference in sway velocity after contraction in the right lateral flexion, right anterior oblique and left anterior oblique direction of contraction. All the subjects showed oriented whole-body leaning in the plane of the contraction. The experiment produced significantly altered and perceived altered balance in this group of physically fit individuals. The results may contribute to our understanding of normal functional capacities of athletes and will provide a basis for further investigation in healthy non-athletes and participants that have suffered neck injuries. This may ultimately help develop accurate and valid rehabilitation outcome measures. Key pointsUsing a percentage of MVIC permits to proportionally fatigue various neck muscle groups evenlyFatigue of different neck muscle groups will alter balance differentlyFatigue of muscles producing extension and posterior oblique will alter balance the most although subjects perceive a greater altered balance after lateral flexion.
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PMID:The effects of cervical muscle fatigue on balance - a study with elite amateur rugby league players. 2479 Apr 87

Training is a mainstay in the clinical management of neck pain, yet, effects of various training protocols are only small to moderate and improvements are required. Previous investigations of the nervous system indicate a correlation between neuroplastic adaptation to training and functional recovery. The interaction between neck pain and training thus needs further exploration. This was a randomized experimental study of the effects of experimental neck pain and training on corticomotor excitability. Healthy volunteers were randomized to training and experimental neck pain, training and no pain, and pain and no training. Primary endpoints were corticomotor excitability assessed by transcranial magnetic stimulation and electromyography measured as changes in amplitudes and latencies of motor evoked potentials (MEPs), recorded at baseline and after 30 min, 1 h, and 1 week. Additionally, correlations between changes in MEPs and motor learning, effects of pain and concomitant neck training on pain, muscle strength, and fatigue were investigated. Data were analyzed by repeated measurement ANOVA, paired t tests, Grubbs' outlier test and correlation coefficients. Results indicated that neck pain and training significantly enhanced the inhibition of the amplitudes of the MEPs for 1 week. The results indicate that moderate neck pain and training induce long-lasting inhibition of the corticomotor pathways. This inhibition may limit the outcome of neck training in painful conditions in contrast to pain-free training conditions.
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PMID:The role of neuroplasticity in experimental neck pain: a study of potential mechanisms impeding clinical outcomes of training. 2481 94


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