Neck Solutions Blog

February 14, 2012

Long periods with uninterrupted muscle activity related to neck and shoulder pain

Filed under: Neck Pain,Shoulder Pain — Administrator @ 10:07 am

Long periods with uninterrupted muscle activity related to neck and shoulder pain

From: Work. 2012 Jan 1;41(0):2535-8

The aim was to analyze the relationship between periods with uninterrupted neck muscle activity for ≥4 min and neck and shoulder pain. The trapezius muscle activity was recorded bilaterally on 40 young workers and students during a full shift. Neck and shoulder pain, mechanical work load and decision control were reported at the same time as the muscle activity recording and 6 months later. A dose-response relationship was found between uninterrupted muscle activity and neck and shoulder pain, with a ten-fold higher risk for the group with more than half, compared to less than a third, of the shift with uninterrupted muscle activity. Self-reported mechanical work load showed a small but protective effect related to pain. Gender and decision control did not emerge as important risk factors in this model. In conclusion, this study indicates that work or other exposures that contains long periods with uninterrupted neck muscle activity of 4 min duration or longer should be minimized to reduce risk of neck and shoulder pain.

Long periods with uninterrupted muscle activity related to neck and shoulder pain

February 12, 2012

Notebook computer use with different monitor tilt angle: effects on posture, muscle activity and discomfort of neck pain users

Filed under: Neck Pain,Posture — Administrator @ 5:25 am

Notebook computer use with different monitor tilt angle: effects on posture, muscle activity and discomfort of neck pain users.

From: Work. 2012 Jan 1;41(0):2591-5

This study aimed to evaluate the posture, muscle activities, and self reported discomforts of neck pain notebook computer users on three monitor tilt conditions: 100°, 115°, and 130°. Six subjects were recruited in this study to completed typing tasks. Results showed subjects have a trend to show the forward head posture in the condition that monitor was set at 100°, and the significant less neck and shoulder discomfort were noted in the condition that monitor was set at 130°. These result suggested neck pain notebook user to set their monitor tilt angle at 130°.

February 10, 2012

Can a functional postural exercise improve performance in the cranio-cervical flexion test

Filed under: Neck Pain,Posture — Administrator @ 11:57 am

Can a functional postural exercise improve performance in the cranio-cervical flexion test? – A preliminary study.

Man Ther. 2012 Feb 4. [Epub ahead of print]

There is considerable evidence that neck pain is associated with alterations in spatial and temporal behaviors of the neck muscles and changes in muscle properties. Changes have been identified in various neck and axio-scapular muscles and the neck flexors have received particular attention. There is some functional specificity between superficial and deep flexors. Superficial muscles, sternocleidomastoid and anterior scalenes are major contributors to flexion torque while deep neck flexor muscles (longus capitis and colli) have an important role in supporting the normal neck curve and segments in posture and movement.

Of clinical and functional relevance, reduced activation of the deep neck flexor muscles has been identified in association with increased activation of the superficial flexor muscles in studies using the cranio cervical flexion test in patients with a variety of neck disorders. The evidence of reduced deep neck flexor activity comes from laboratory studies using a direct measure of electromyographic (EMG) amplitudes. A number of clinical studies have limited measurement to sternocleidomastoid activity using surface EMG electrodes and have indirectly inferred reduced deep neck flexor function on the evidence of an inverse relationship between sternocleidomastoid, anterior scalenes and deep neck flexor muscle activity from laboratory measures of neck pain patients.

Training the deep neck flexor muscles is regarded as an important component of neck rehabilitation programs because of the functional importance of the deep neck flexor and the evidence suggesting that the altered pattern of activation between the deep and superficial flexors (1) does not correct automatically with pain relief and (2) persists without specific training. Many factors influence the magnitude of neck pain. It is uncertain whether changes in muscle function are a cause or effect of pain, but a relationship has been shown between neck pain intensity and activity in the deep (lesser) and superficial (greater) neck flexor muscles. Concomitantly, the degree of pain reduction in patients with chronic neck pain has a relationship with the change in deep neck flexor activity following training. Clinical trials also support the effectiveness of training the deep neck flexor muscles and restoring their normal temporal relationship with the superficial flexors as a component of a multimodal program for the rehabilitation of neck pain disorders.

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February 7, 2012

Low back pain and neck pain as predictors of sickness absence among municipal employees

Filed under: Back Pain,Neck Pain — Administrator @ 9:45 am

Low back pain and neck pain as predictors of sickness absence among municipal employees

From: Scand J Public Health. 2012 Feb 3. [Epub ahead of print]

To study whether having ever had local low back pain, sciatica, neck pain, or some combination of low back pain and neck pain, predicts sickness absence among municipal employees. The study sample (n=6911, 80% women, response rate 67%) included employees of the City of Helsinki who reached the age of 40, 45, 50, 55, or 60 years between 2000-02. Survey data on pain, working conditions, and health behaviours were linked to register data on sickness absence for three subsequent years. Sickness absence was categorised as self-certified (lasting for 1-3 days) and medically certified (lasting for 4 days or more) and the number of spells during the follow up was analysed using Poisson regression analysis.

In women, medically certified sickness absence was predicted by sciatica, neck pain and the combination of sciatica and neck pain, allowing for working conditions, body mass index, and smoking. Local low back pain did not predict medically certified sickness absence. Self-certified sickness absence was modestly predicted by all pain categories and by neck pain alone and with local low back pain or sciatica in men.

Medically certified sickness absence was predicted by sciatica and neck pain, but not by local low back pain. The association was accentuated in those with both sciatica and neck pain. Pain combinations may have a stronger effect on work ability than pain in one location.

February 4, 2012

Cervical radiculopathy: Study protocol of a randomised clinical trial evaluating the effect of mobilisations and exercises targeting the opening of intervertebral foramen

Filed under: Neck Pain — Administrator @ 6:15 am

Cervical radiculopathy: Study protocol of a randomised clinical trial evaluating the effect of mobilisations and exercises targeting the opening of intervertebral foramen

From: BMC Musculoskelet Disord. 2012 Jan 31;13(1):10. [Epub ahead of print]

Cervical or neck pain is a general term used to designate any musculoskeletal disorder in the cervical region. Various pathologies encompass that generic definition and are most commonly related to degenerative changes or inflammation of cervical structures such as intervertebral discs, articular facets joints or nerve roots. Neck pain is a very common, disabling and costly condition. According to a review by the Neck Pain Task Force pertaining the prevalence of neck pain in industrialised countries, annual prevalence is situated within 30 to 50% in adult populations. In accordance with these results, in Canada, a bi-annual prevalence of 54% has been reported.

Cervical radiculopathy forms an important subgroup of neck disorders and, although less prevalent than general neck pain, it has been shown to lead to more severe pain and disability. Cervical radiculopathy primarily results from an inflammation of a cervical nerve root induced by a lesion reducing the intervertebral foramen. This reduction is primarily induced by a herniated disc or a degenerative lesion of zygapophysial joints. Typical symptoms of cervical radiculopathy include pain in the cervical or periscapular region and in the upper limb, as well as neurological signs such as paresthesia, numbness, weakness and loss of reflexes in the affected nerve root distribution.

The diagnosis of cervical radiculopathy is commonly made through patient history and physical examination. A a positive response to the following four clinical tests results in a high predictive value for a diagnosis of cervical radiculopathy: 1 – cervical distraction test, 2 – upper limb tension test, 3 – Spurling test, and 4 – ipsilateral cervical rotation reduced by more than 60 degrees. If all four of these tests are positive, the positive likelihood ratio (LR+) of having a cervical radiculopathy is 30. If three out of these four tests are positive, the LR+ decreases to 6. A LR+ superior to 10 is considered large, and between 5 and 10 moderate; thus, it increases the possibility that the impairment in question is present. Hence, by combining these clinical tests, the possibility of obtaining a good clinical diagnostic accuracy in patients presenting signs and symptoms compatible with cervical radiculopathy is high.

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January 18, 2012

Effect of backpack load carriage on cervical posture in primary schoolchildren

Filed under: Neck Pain,Posture — Administrator @ 9:43 am

Effect of backpack load carriage on cervical posture in primary schoolchildren

From: Work. 2012 Jan 1;41(1):99-108

This study examined the effects of various backpack loads on elementary schoolchildren’s posture and postural compensations as demonstrated by a change in forward head position. A convenience sample of 11 schoolchildren, aged 8-11 years participated. Sagittal digital photographs were taken of each subject standing without a backpack, and then with the loaded backpack before and after walking 6 minutes (6MWT) at free walking speed. This was repeated over three consecutive weeks using backpacks containing randomly assigned weights of 10%, 15%, or 20% body weight of each respective subject. The craniovertebral angle was measured using digitizing software, recorded and analyzed.

Subjects demonstrated immediate and statistically significant changes in craniovertebral angle, indicating increased forward head positions upon donning the backpacks containing 15% and 20% body weight. Following the 6MWT, the craniovertebral angle demonstrated further statistically significant changes for all backpack loads indicating increased forward head postures. For the 15 & 20% body weight conditions, more than 50% of the subjects reported discomfort after walking, with the neck as the primary location of reported pain. Backpack loads carried by schoolchildren should be limited to 10% body weight due to increased forward head positions and subjective complaints, primarily neck pain, at 15% and 20% body weight loads.

January 14, 2012

Neck pain: manipulation of your neck and upper back leads to quicker recovery

Filed under: Chiropractic,Neck Pain — Administrator @ 5:23 am

Neck pain: manipulation of your neck and upper back leads to quicker recovery

From: J Orthop Sports Phys Ther. 2012;42(1):21.

Neck pain is very common and fortunately resolves quickly in most individuals. However, in certain cases neck pain can last longer and result in chronic pain, limited neck motion, and disability. In fact, chronic neck pain is the second leading cause of workers’ compensation claims in the United States. Treatments that can quickly reduce pain, increase motion, and improve the ability of the muscles to protect the neck may help decrease long-term disability associated with neck pain. A variety of manual therapy treatments are currently used to manage neck pain. These treatments include mobilization, which slowly and repeatedly moves the neck joints and muscles, and manipulation, which delivers a single, small, quick movement to the joints and muscles.

Researchers treated 107 patients. About half of these patients received a manipulation of the neck, on the part closest to the head, and of the upper back. The other patients received manual therapy that mobilized the spine without using manipulation. After 48 hours, the patients who received the manipulation treatment experienced a 58% decrease in pain and a 50% decrease in disability. By contrast, patients who received the mobilization treatment only had a 13% decrease in pain and actually showed a 13% increase in disability. In addition, the patients who received the manipulation had increased motion and improved control of their neck muscles compared to the patients in the mobilization group. The researchers concluded that the combination of upper neck and back manipulation was more effective in the first 48 hours of treatment than the mobilization treatment. Potential benefits include less pain, better neck motion, and improved ability to perform daily activities.

Chiropractors have known this for decades! Unfortunately, assimilation by the medical profession is a priority and ultimately relates to greed through political means.

Source: Neck pain: manipulation of your neck and upper back leads to quicker recovery

January 12, 2012

Ten-year survey reveals differences in GP management of neck and back pain

Filed under: Back Pain,Neck Pain — Administrator @ 11:51 am

Ten-year survey reveals differences in GP management of neck and back pain

From: Eur Spine J. 2012 Jan 8. [Epub ahead of print]

Clinical guidelines provide similar recommendations for the management of new neck pain and low back pain but it is unclear if general practitioner’s (GP) care is similar. While GP’s management of low back pain is well documented, little is known about GP’s management of neck pain. We aimed to describe GP’s management of new neck pain and compare this to GP’s management of new low back pain in Australia between April 2000 and March 2010. All GP-patient encounters for a new (i.e. first visit to any medical practitioner) neck pain or low back pain problem were compared in terms of treatment delivered, referral patterns and requests for laboratory and imaging investigations.

General practitioners in Australia have managed new neck pain and low back pain problems at a rate of 3.1 and 5.8 per 1,000 GP-patient encounters, respectively. GP’s primarily utilised medications, in particular non-steroidal anti-inflammatory drugs, to manage new neck and low back pain problems and referred approximately 25% of all patients for imaging. Patients with new neck pain are more frequently managed using physical treatments and were referred more often to allied health professionals and specialists. In comparison, patients with new low back pain were managed more frequently with medication, advice, provision of a sickness certificate and ordering of pathology tests.

This is the first time GP management of a new episode of neck pain has been documented using a nationally representative sample and it is also the first time that the management of back and neck pain has been compared. Despite guidelines endorsing a similar approach for the management of new neck pain and low back pain, in actual clinical practice Australian GPs manage these two conditions differently.

January 10, 2012

Clinical and medicolegal characteristics of neck injuries

Filed under: Neck Pain,Whiplash — Administrator @ 9:45 am

Clinical and medicolegal characteristics of neck injuries

From: Coll Antropol. 2011 Sep;35 Suppl 2:187-90

The predominance in performing surgery of major spine injuries by neurosurgeons usually has the consequence of treating all types of spine injuries by neurosurgeons – neurotraumatologists. In the neurosurgical wards of Clinical Hospital Rijeka, the authors take care of the majority of these patients, following both the major, as well as minor whiplash injuries of the neck. The article overviews patients admitted in the one year period (October 1st 2009-October 1st 2010) where 1077 cases of neck injuries were analyzed. Vast majority of these injuries were due to traffic accidents (over 94%), and only a small proportion were serious injuries that needed a surgical approach decompression and stabilization (c1%). The authors analyzed minor neck injuries thoroughly both because of the increasing number of whiplash neck injuries and because more complicated diagnostic and therapeutic protocols occupy too much time in the ambulatory practice of neurotraumatologists each year thus representing a growing financial burden to the health organizations and to the society as a whole.

The results proved that the majority of the injured are male (over 60%), young and active (almost two thirds 21-40 years of age), had commonly sustained a Quebec Task Force (QTF) injury of grades 2 and 3 (almost 90%), and, if properly treated, recovered completely after a mean therapy period of ten weeks. Only a minority complained of prolonged residual symptoms, some of them connected with medico-legal issues (less than 20%). The results shown are in contrast with the general opinion that malingerers in search of financial compensation prevail in these cases, and leads to the conclusion that minor neck injuries (including whiplash) as well as Whiplash Associated Disorder are real traumatological entities, that have to be seriously dealt with.

January 6, 2012

Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain

Filed under: Neck Pain — Administrator @ 11:29 am

Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain A Randomized Trial

From: Ann Intern Med. 2012 Jan 3;156

Neck pain is a prevalent condition that nearly three quarters of persons experience at some point in their lives. One of the most commonly reported symptoms in primary care settings, neck pain results in millions of ambulatory health care visits each year and increasing neck health care costs. Although it is not life-threatening, neck pain can have a negative effect on productivity and overall quality of life.

Chiropractors, physical therapists, osteopaths, and other neck health care providers commonly apply spinal manipulation, a manual therapy, for neck pain conditions, and home exercise programs and medications are also widely used. Recent Cochrane reviews report insufficient evidence to assess the effectiveness of commonly used medications or home exercise programs for the treatment of acute neck pain. The evidence for spinal manipulation is similarly limited, with only low-quality evidence supporting its use for neck pain of short duration.

The goal was to test the hypothesis that spinal manipulation therapy is more effective than medication or home exercise with advice (neck exercises) for acute and subacute neck pain.

Neck exercises with advice was provided in two 1-hour sessions, 1 to 2 weeks apart, at the universityaffiliated outpatient clinic. Six therapists provided instruction to participants. The primary focus was simple selfmobilization exercise (gentle controlled movement) of the neck and shoulder joints, including neck retraction, extension, flexion, rotation, lateral bending motions, and scapular retraction, with no resistance. The delivery method was 1-on-1, and the program was individualized to each participant’s abilities, tolerance, and activities of daily living.

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