Neck Solutions Blog

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

Characteristics of neck and shoulder pain (called katakori in Japanese) among members of the nursing staff

From: J Orthop Sci. 2011 Nov 18. [Epub ahead of print]

The characteristics of neck and shoulder pain, called katakori in Japanese, have not been well documented to date. The aim of this study was to clarify the characteristics of neck and shoulder pain through a questionnaire survey of members of the nursing staff.

The study population consisted of 484 nursing staff members of Gunma University Hospital in Japan. The questionnaire involved information on age, body mass index (BMI), gender, psychological stress at work, musculoskeletal pain at other anatomic sites (elbow/wrist, lumbar and knee), smoking history, and hypertension. If subjects had neck and shoulder pain, they were asked about any coexisting symptoms, the utilization of health services, and the precise location of neck and shoulder pain.

The total study population included 393 persons after 91 persons were excluded for various reasons. The point prevalence of neck and shoulder pain was 68.1% (268 of 393). Age, BMI, smoking history, and hypertension showed no significant trend for the prevalence of neck and shoulder pain in the univariate analyses.

The occurrence of neck and shoulder pain was significantly higher in subjects with psychological stress, elbow/wrist pain, lumbar pain, and knee pain, respectively. A multivariate logistic regression analysis showed that gender, psychological stress, elbow/wrist pain, and lumbar pain were significantly associated with the occurrence of neck and shoulder pain. One hundred fifty-eight of those with neck and shoulder pain (58.9%) reported coexisting symptoms, and the most common was headache. Fifty-seven (21.2%) of the subjects with neck and shoulder pain had consulted medical or health practitioners, and bone setting was the most common service provider. The most common area of neck and shoulder pain was the superior part of the trapezius.

This study confirmed that neck and shoulder pain, katakori in Japanese, is a prevalent problem in a nursing staff, and several factors associated with neck and shoulder pain were identified.

Y exercises for correcting the most common faulty movement pattern of the shoulder/neck region

From: J Bodyw Mov Ther. 2011 Jul;15(3):391-4. Epub 2011 May 28

Shoulder and neck problems frequently persist even after rest, physical therapy, medication, injections and even surgery. One of the great misunderstandings about musculoskeletal pain is that it is due to some injury or
structural pathology seen on an MRI or X-Ray. In spite of more and more structural imaging pain problems are becoming more persistent and chronic!

Over the past few years a new more functional approach has come into focus. Modern assessment of musculoskeletal pain has shifted from diagnosis of structural pathology to functional pathology. Dysfunction is nowrealized to be the“missing link” in the management of persistent musculoskeletal pain. In particular, the assessment and correction of faulty movement patterns which are the real source of biomechanical overload in the kinetic chain.

It is typical to have shoulder or neck pain without any relevant structural pathology on an MRI or X-Ray. Many
people have also been shown to have arthritis, or other structural problems such as a rotator cuff tear without
having any symptoms whatsoever. What then is it that predisposes one person to have pain or loss of physical capacity in one’s sport or activity?

A recent Stanford University study found that over 20% of their NCAA collegiate volleyball players WITHOUT shoulder problems had either tears or arthritic degeneration in their shoulders. The authors concluded that IF someone with pain has such structural abnormalities it should not be automatically assumed that they need surgery or need to live with the pain. Instead the real source of pain usually lies elsewhere.

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Implementation of neck/shoulder exercises for pain relief among industrial workers: A randomized controlled trial.

BMC Musculoskelet Disord. 2011 Sep 21;12(1):205. [Epub ahead of print]

Musculoskeletal disorders comprise a major burden on individuals and public health systems in North America and Europe. Neck and shoulder pains are among the most frequent health complaints among adults. Physical workplace factors such as repetitive work tasks, static contractions, and tiring postures are related to neck and shoulder pain. Studies have evaluated different types of physical exercise for treating neck and shoulder pain. While moderate to strong evidence for the effectiveness of strength training for relieving neck pain among office workers exists, evidence lacks among other occupational groups. Laboratory technicians – commonly exposed to high levels of strain in the neck and shoulders due to prolonged static loadings – show high prevalence of neck and shoulder pain. Based on previous research among office workers, investigating the effect of strength training on neck and shoulder pain among laboratory technicians is therefore relevant.

A British health survey reported that among the general population only 37% of men and 24% of women fulfilled public recommendations of physical activity. Thus, regular physical exercise is challenging for many people. In consequence, low adherence to exercise programs can negatively affect the outcome of randomized controlled trials, even in high quality studies. The major reason for not adhering to physical exercise is “lack of time”. Thus, workplace interventions with physical exercise during work hours and together with colleagues may reach people with low motivation for leisure physical exercise.

The present study has two major aims: Firstly, to evaluate the effect of strength training intervention at the workplace on non-specific neck and shoulder pain among industrial workers. Secondly, to describe the implementation process and adherence to the program.

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Prevalence and anatomical location of muscle tenderness in adults w ith nonspecific neck/shoulder pain.

From: BMC Musculoskelet Disord. 2011 Jul 22;12(1):169.

A high prevalence of upper extremity pain exists among adults working in sedentary occupations. Neck and shoulder pain is a risk factor for long-term sickness absence among whitecollar workers, and every other office worker experience neck and shoulder pain on a weekly basis. Pain symptoms are believed to worsen in response to prolonged static muscle activity and/or repetitive job tasks, causing muscle metabolic disturbances.

There is a strong correlation between reported neck and shoulder pain and clinically verified muscle tenderness. Especially, tenderness of the upper trapezius muscle often co-exists with neck and shoulder pain. The upper trapezius muscle is – due to its bulky and superficial nature – well suited for clinical research, and displays clear physiological differences between symptomatic and non-symptomatic individuals regarding electromyographic activity, muscle strength, muscle fiber morphology, stem cell content, and intramuscular metabolites. In spite of the inordinate focus on the upper trapezius, other muscles of the neck and shoulder complex may be affected as well and should therefore not be overlooked when treating neck and shoulder pain.

A clinical protocol for diagnosing disorders of the neck, shoulder and arm – e.g. tension neck syndrome, frozen shoulder and lateral epicondylitis has been extended to include the diagnosis of trapezius myalgia – frequent neck pain with co-existing tenderness and tightness of the upper trapezius muscle. The overall prevalence of these disorders is low to modest and many people experience non-specific neck and shoulder pain, i.e. pain in absence of the aforementioned clinically diagnosed disorders.

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Comparing biofeedback with active exercise and passive treatment for the management of work-related neck and shoulder pain: a randomized controlled trial.

From: Arch Phys Med Rehabil. 2011 Jun;92(6):849-58.

The study objective was to compare the effects of biofeedback with those of active exercise and passive treatment in treating work-related neck and shoulder pain in a randomized controlled trial with 3 intervention groups and a control group.

Participants were recruited from outpatient physiotherapy clinics and a local hospital. All participants reported consistent neck and shoulder pain related to computer use for more than 3 months in the past year and no severe trauma or serious pathology. A total of 72 potential participants were recruited initially, of whom a smaller group of individuals (n=60) completed the randomized controlled trial.

The 3 interventions were applied for 6 weeks. In the biofeedback group, participants were instructed to use a biofeedback machine on the bilateral upper trapezius muscles daily while performing computer work. Participants in the exercise group performed a standardized exercise program daily on their own. In the passive treatment group, interferential therapy and hot packs were applied to the participants’ necks and shoulders. The control group was given an education booklet on office ergonomics.

Pain (visual analog scale), neck disability index, and surface electromyography were assessed preintervention and postintervention. Pain and neck disability were reassessed after 6 months.
Postintervention, average pain and neck disability scores were reduced significantly more in the biofeedback group than in the other 3 groups, and this was maintained at 6 months. Cervical erector spinae muscle activity showed significant reductions postintervention in the biofeedback group, and there were consistent trends of reductions in the upper trapezius muscle activity.

Six weeks of biofeedback training produced more favorable outcomes in reducing pain and improving muscle activation of neck muscles in patients with work-related neck and shoulder pain.