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ObjectiveTo investigate the characteristics of health-related physical fitness of patients with chronic neck pain, and the relationship between neck pain and physical fitness. MethodsFrom Match to June, 2020, 30 healthy controls and 30 patients with chronic neck pain in Dalian University of Technology were included. They were assessed with Neck Disability Index (NDI) and Visual Analog Scale for pain (VAS). The body composition, grip strength (dominant), shoulder joint flexibility, cardiopulmonary endurance and neck muscle endurance of all the participants were measured. ResultsThe content of standardized subcutaneous fat was more, and the trunk muscle content was less in the patients than in the healthy controls, while the standardized grip strength, endurance of neck flexor and extensor, right shoulder flexibility, absolute maximum oxygen uptake were all poorer (|t| > 2.088, P < 0.05). The score of VAS correlated (P < 0.05) with the score of NDI score (r = 0.407), grip strength (r = -0.406), endurance of neck extensor (r = -0.384), right shoulder joint flexibility (r = -0.551) and absolute value of maximal oxygen uptake (r = -0.510). ConclusionHealth-related physical fitness has been impaired for patients with chronic neck pain, and correlates with the intensity of pain.
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@#Objective To evaluate the effects of spinal manipulation therapy (SMT) on chronic nonspecific neck pain (CNSNP) by using World Health Organization Family International Classifications (WHO-FICs). Methods Randomized controlled trials (RCTs) about the effects of SMT on CNSNP were searched from PubMed, Web of Science, Cochrane Library, EMBASE, EBSCO, CBM and CNKI from database establishment to December 31st, 2021. At least two researchers extracted the data. Cochrane bias risk assessment tool and Physiotherapy Evidence Database Scale were used to evaluate the quality of the included articles. Revman 5.4 software and Stata 16.0 software were used for meta-analyses and publication bias analysis respectively. Results A total of 15 RCTs that represented 1 067 participants were evaluated. In terms of body functions, compared with the control group, SMT significantly reduced Visual Analog Score for pain (MD = -0.85, 95%CI -1.06 to -0.63, P < 0.00001) and Numerical Rating Scale (MD = -0.92, 95%CI -1.29 to -0.55, P < 0.001), increased pressure pain thresholds (SMD = 0.67, 95%CI 0.47 to 0.86, P < 0.001), cervical range of motion (ROM) of flexion/extension (SMD = 0.51, 95%CI 0.33 to 0.68, P < 0.001) and rotation (SMD = 0.20, 95%CI 0.01 to 0.38, P = 0.04), improved root mean square of cervical muscles electromygraphy (MD = 2.17, 95%CI 0.06 to 4.29, P = 0.04), but not significantly in cervical ROM of lateral flexion (SMD = 0.19, 95%CI -0.00 to 0.38, P = 0.06), cervical strength (SMD = -0.18, 95%CI -0.84 to 0.49, P = 0.60) and endurance (SMD = 0.18, 95%CI -0.39 to 0.75, P = 0.53). In term of activities and participation, SMT significantly improved cervical disability (MD = -0.96, 95%CI -1.55 to -0.38, P = 0.001), but not significantly in health status of patients with CNSNP (SMD = 0.08, 95%CI -0.03 to 0.20, P = 0.15). Conclusion SMT could improve pain intensity, pain sensitivity, cervical ROM and disability in patients with CNSNP, but its efficacy on muscle function, proprioception and health status is unclear.
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Background: Neck pain is one of the most frequently reported complaints of the musculoskeletal system. Treatments for neck pain are varied, including physiotherapy, chiropractic, analgesics, and other drugs or steroid injections. Neck pain frequently recurs in 50% to 80% of people. Symptoms of neck pain range from mild discomfort to severe disability and can interfere with daily activities and quality of life. Moreover, incidents of neck pain can be associated with headache, arm pain or even neurological deficits. Acupuncture and other traditional Chinese techniques have been widely used as an alternative to more conventional treatments for musculoskeletal pain. This case report investigates the effectiveness of a combination of acupuncture, moxibustion, cupping, and tuina in treating chronic neck pain. Case presentation: An 85-year-old patient diagnosed with cervical spondylosis was suffering from chronic neck pain and muscle spasm for several years. He had undergone all conventional treatments for spondylosis without any long-lasting effects. He was interested in trying out traditional Chinese techniques. He was treated for 8 weeks with Acupuncture, Moxibustion, Tui Na and Cupping. The treatment outcomes were measured on Day1, after 4 weeks and at the end of 8 weeks of treatment. The primary outcome measures used were Visual Analogue Scale (VAS) and Neck Disability Index (NDI). After 8 weeks of treatment, the patient reported full recovery from pain and acute spasms of his neck muscles. VAS score reduced from 5 to 1. Neck Disability Index score reduced from 20 to 08. His quality of life improved as measured by SF-12 score which reduced from 33 to 29. Conclusion: Traditional Chinese therapies can be undoubtedly used as an adjunct to conventional therapies like physiotherapy or chiropractic to treat chronic neck pain. However, long term studies are needed to validate the findings of this study on a larger population.
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Background: Chronic neck pain is a common musculoskeletal dysfunction, and Manual Therapy is one of the effective treatment modalities, but underlying mechanisms of action are unclear. The study's purpose was to investigate the short-term effect of mobilization-manipulations on patient’s symptoms and to detect changes in the concentration of inflammatory biomarker interleukin-1b. Methods: Twenty-two patients aged 20-50 years with chronic neck pain, randomly assigned into two groups. The study group received nine sessions of a three-week Manual Therapy intervention. The control group received SHAM Manual Therapy of the same dosage. Pain and functionality measures conducted before and after the intervention via NPRS and NDI scales, respectively. Blood samples collected at baseline, after the first session and post-intervention, detecting IL-1β concentration, using the corresponding ELISA kit. Mixed ANOVA statistical analysis implemented for differences in the GROUP-TIME factors. Results: There was a significant statistical interaction between factors and significant main effects on pain, functionality, and IL-1β (p <.05). IL-1β was statistically significant reduced (p <.05) at second measurement for the study group, but not significantly reduced (p> .05) between second and final measurement. No statistical significance was found for the control group on any of the dependent variables across measures. Conclusion: Patients with chronic mechanical pain showed significant pain and functionality improvement after manual therapy application. The underlying mechanism of action seems to relate with a reduced IL-1b concentration of reinforcing future research at relevant pain biomarkers.
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Background: Chronic neck pain is observed to be commonly kindred with forward head posture (FHP). Rib cage mechanics is found to be altered that decreases thoracic mobility. This reduced mobility of thorax reduces the effectiveness of diaphragm, intercostals, and abdominal muscles in terms of ventilation. Therefore this study was done to evaluate the effectiveness of exercises meant for enhancing the stability of the neck with feedback on neck stabilization exercises with feedback in improving the respiratory status. Methods: This was an experimental study. Based on inclusion & exclusion criteria, 100 subjects (54 males and 46 females) enrolled for the study, which was further allotted into Experimental and Control groups. The experimental group was given Cervical Stabilization Exercise with feedback in addition to routine Physiotherapy treatment. Control group was given only regular Physiotherapy treatment for six weeks. The digital camera assessed the FHP by measuring of Craniovertebral Angle (CVA). Spirometry assessed pulmonary function (FEV1) and Micro RPM assessed inspiratory muscle strength (PImax). All measurements were taken on the day of study, on 3rd and 6th week Results: Significant reduction in forward head posture measured by improvement in Craniovertebral angle, improvement in Inspiratory muscle strength (PIMax) and pulmonary functions (FEV1) were found in the group that received cervical stabilization exercises with feedback along with the conventional Physiotherapy (p< 0.05). Therefore it is suggested that cervical stabilization exercises correct the head posture and helps to improve the biomechanics of respiratory muscles. Conclusion: Cervical stabilization exercise is an effective approach to correct the forward head posture, and it should be included in the intervention measures of patients with forward head posture.
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OBJECTIVE@#To evaluate the effectiveness in treatment of chronic neck pain with the direct moxibustion of small moxa cone and explore the dose-effect relationship in treatment of chronic neck pain with different small moxa cones.@*METHODS@#A total of 120 patients with chronic neck pain were randomized into a 3-moxa-cone group, a 5-moxa-cone group, a 7-moxa-cone group and a sham-moxibustion group, 30 cases in each one. Fengchi (GB 20), Tianzhu (BL 10), Jingbailao (EX-HN 15), Jianzhongshu (SI 15) and Jianjing (GB 21) were selected in each of the groups. The direct moxibustion with 3, 5 and 7 moxa cones as well as the sham-moxibustion therapy were provided successively in each of the above groups. In the sham-moxibustion group, the lower 1/3 section of moxa cone (about 1.5 mm in length) was soaked in oil before used in treatment. In each group, the treatment was given twice a week, for 10 treatments totally. Separately, before treatment, after treatment and in 1-month follow-up, the scores of the Northwick Park neck pain questionnaire (NPQ), the scores of McGill pain questionnaire (MPQ) and the local pressure pain threshold (PPT) were observed in each group. After treatment and in 1-month follow-up, the therapeutic effects were evaluated in each group.@*RESULTS@#After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were reduced as compared with those before treatment separately (all 0.05). After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were lower as compared with the sham-moxibustion group separately (all 0.05).@*CONCLUSION@#The direct moxibustion therapy with different small-moxa-cones effectively relieves chronic neck pain. There is a trend of improvement of the therapeutic effects with increase of the numbers of moxa cones.
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Humans , Acupuncture Points , Moxibustion , Neck Pain , Therapeutics , Pain Measurement , Surveys and QuestionnairesABSTRACT
@#Objective To explore the clinical effect of inner heating dry needle therapy on nonspecific chronic neck pain (NCNP). Methods From October, 2017 to March, 2018, 60 patients with NCNP were randomly divided into needle group (n=30) and magner group (n=30). The needle group received inner heating dry needle therapy, and the magner group received hot magner therapy. They were measured the strain ratio (SR) of bilateral trapezius muscles, scalp clamp muscles, cephalospinal muscles, semispinalis muscles and multifidus muscles with ultrasound elastography before, and one week and one month after treatment, respectively, while they were assessed with Visual Analogue Scale (VAS) of pain and Neck Disability Index (NDI). Results The scores of VAS and NDI decreased in both groups one week and one month after treatment (t>2.693, P<0.05), and decreased more in the needle group than in the magner group (F>8.048, P<0.001). SR of all the muscles decreased in the needle group one week and one month after treatment (F>6.22, P<0.01), and only decreased in the right cephalospinal muscles in the magner group (F=4.35, P<0.05).Conclusion Inner heating dry needle therapy could recover the neck muscle elasticity to relieve pain and improve ceivical function in patients with NCNP.
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PURPOSE: The purpose of this study was to investigate the relationship among pain, range of motion of the neck, neck disability index and grip strength after thoracic manipulation and cervical stabilization training in patients with chronic neck pain. METHODS: In this study, twelve subjects with chronic neck pain were included. All participants had thoracic manipulation and cervical stabilization training. Intervention was conducted three times per a week, for 4 weeks. The visual analogue scale (VAS), range of motion of neck, neck disability index (NDI), as well as the grip strength before and after intervention were measured in all participants. Paired ttest was used to compare variables before and after intervention. Pearson correlation analysis was used to identify the correlations between the variables. RESULTS: All variables after the intervention were significantly improved. There was a significant negative correlation between VAS and flexion angle of the neck (r=−0.669, p<0.05). Moreover, there was a significant positive correlation between NDI and VAS (r=0.636, p<0.05), and a significant negative correlation between NDI and flexion angle of the neck (r=−0.692, p<0.05). CONCLUSION: Patients with reduced pain following therapeutic intervention illustrated that there would be an improvement in the flexion angle rather than the extension angle of the neck, and that those with increased flexion angle would have less restriction of activities in daily living.
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Humans , Hand Strength , Neck Pain , Neck , Range of Motion, Articular , Statistics as TopicABSTRACT
@#Chronic neck pain is a common chronic musculoskeletal disorder. Research on neck muscle fatigue contributed to the understanding the pathogenesis of chronic neck pain. The influences caused by the neck muscle fatigue, such as the change of cervical proprioception and balance, could easily lead to chronic injury. Changes in morphology and recruitment strategy of cervical muscle could decrease muscle endurance, which bring about further damage. Targeted therapy and training can relieve muscle fatigue, improve muscle function, and reduce the recurrence rate. Surface electromyography has unique advantages in the evaluation of cervical muscle fatigue. The assessment of muscle fatigue could provide for assistance to the treatment and curative effect of chronic neck pain.
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Chronic neck pain is a common chronic musculoskeletal disorder. Research on neck muscle fatigue contributed to the under-standing the pathogenesis of chronic neck pain. The influences caused by the neck muscle fatigue, such as the change of cervical propriocep-tion and balance, could easily lead to chronic injury. Changes in morphology and recruitment strategy of cervical muscle could decrease muscle endurance, which bring about further damage. Targeted therapy and training can relieve muscle fatigue, improve muscle function, and reduce the recurrence rate. Surface electromyography has unique advantages in the evaluation of cervical muscle fatigue. The assess-ment of muscle fatigue could provide for assistance to the treatment and curative effect of chronic neck pain.
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@#Chronic neck pain is a common chronic musculoskeletal disorder. Research on neck muscle fatigue contributed to the understanding the pathogenesis of chronic neck pain. The influences caused by the neck muscle fatigue, such as the change of cervical proprioception and balance, could easily lead to chronic injury. Changes in morphology and recruitment strategy of cervical muscle could decrease muscle endurance, which bring about further damage. Targeted therapy and training can relieve muscle fatigue, improve muscle function, and reduce the recurrence rate. Surface electromyography has unique advantages in the evaluation of cervical muscle fatigue. The assessment of muscle fatigue could provide for assistance to the treatment and curative effect of chronic neck pain.
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@#Objective To explore the effect of active resistance exercise therapy on patients with chronic neck pain. Methods 39 femalepatients with neck pain more than 6 months were recruited in treatment group and received active resistance exercise therapy. 21 healthywomen were recruited in control group without any treatment. They were assessed with cervical curve (C2-7 Cobb's angle), CT attenuationvalue of cervical back muscle, neck muscular strength and endurance and visual analog scale (VAS) before and 12 months after treatment.Results Compared with the control group, the cervical curve of the treatment group was obviously less (P<0.05) and there was no significantdifference pre- and post-treatment P>0.05). The CT attenuation value of cervical back muscle was obviously less in the elder controlsthan in the middle aged ones (P<0.05); and was obviously less in the treatment group than in the controls (P<0.05), and not improved aftertreatment (P>0.05). Compared with the control group, neck muscular strength and endurance of the treatment group were obviously less (P<0.05), and improved after treatment (P<0.05). The score of VAS lowered 1 and 12 months after treatment (P<0.05). Conclusion Active resistanceexercise therapy can obviously improve neck muscular strength and endurance and relieve neck pain.
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OBJECTIVE: Radiofrequency facet rhizotomy(RFFR) has been widely performed for treatment of chronic neck pain caused by cervical dorsal ramus syndrome(CDRS). To evaluate the therapeutic effectiveness of RFFR in the patients with CDRS, we analyzed patients with various cervical pathologic conditions. METHODS: The therapeutic results in forty-four patients who underwent RFFR for CDRS from January, 2000 to December, 2002 were analyzed according to the underlying pathologic conditions causing CDRS. The pathologic conditions were sprain (33 cases), herniated nucleus pulposus (6), foraminal stenosis (4), and compression fracture (1). The therapeutic results were evaluated one month after the operation and graded as excellent, good, fair or poor. Treatments were considered successful if the therapeutic results were graded as either excellent or good. RESULTS: The overall success rate in all patients was 72.7%. The success rate for treatment of cases with cervical sprain was 87.9%, but treatment of cases with herniated nucleus pulposus, foraminal stenosis, and fracture showed unsatisfactory results (mean success rate was 27.3%). Some patients complained of transient hypesthesia (4 cases) or transient dull pain at the electrode insertion sites (2 cases). CONCLUSION: RFFR is an effective and safe treatment for CDRS caused by cervical sprain, regardless of the patient's age, the duration of the symptoms, and the presence of radiating pain.