Painful neck movement: an additional differentiating sign between cervical spondylosis and myofascial pain syndrome

ABSTRACT

To find any specific pattern of pain severity during various neck movements in cervical spondylosis versus the myofascial pain syndrome. The study was carried out on 50 myofascial pain syndrome patients and 60 cervical spondylosis patients. Neck pain during neck flexion, extension, rotation and lateral flexion was measured using a numerical rating scale. Pain score during neck flexion was more in myofascial pain syndrome than in cervical spondylosis patients. On the other hand, neck pain during neck extension was more in cervical spondylosis patients than in myofascial pain syndrome patients. There was no statistical significant difference between both groups as regard rotation and lateral flexion. Moreover, neck extension was more painful than neck flexion in 90% of patients with cervical spondylosis. On the other hand, neck flexion was more painful than extension in myofascial pain syndrome patients. This study suggested that comparing pain severity during neck flexion to that during neck extension could be of help not only in differentiating pain of cervical spondylosis from that of MPS, but also in identifying the main cause of neck pain in patients with clinical signs suggestive of MPS and who have concomitant radiological evidence of cervical spondylosis. This could be of therapeutic value