Disability and related factors in patients with chronic cervical myofascial pain
From: Clin Rheumatol. 2009 Feb 18. [Epub ahead of print]
Neck pain is a major causal factor leading to disability loss of work days. One of the common causes of neck pain in the general population is myofacial pain syndrome. Myofacial pain is found in over 35% of individuals who have musculoskeletal complaints and is characterized by the presence of regional pain and painful trigger points in a taught band of muscle which produces patterns of pain referral on palpation in areas of neck strain.
The global estimate of disability may not be the most appropriate outcome measure for neck pain population. Measures of symptom severity and patient reported questionnaires have been advocated as the optimal methods of evaluating the effect of neck pain on the patient and in monitoring change over time. A number of studies have investigated the direct relationships among neck pain impairments and disability. But disability has not been evaluated and associated factors in a homogeneous patient group which includes only cervical myofascial pain patients using neck specific disability scales such as the Neck Pain and Disability Scale.
The aim of this study is to detect whether cervical myofascial pain leads to disability and to determine factors associated with disability in patients with chronic cervical myofascial pain. One hundred-three female patients with chronic cervical myofascial pain and 30 age-matched healthy females participated. Main outcome measurements are visual analog scale, Neck Pain and Disability scale, Beck Depression Inventory and pain pressure threshold measurements from the most usual trigger-point locations of trapezius, levator scapula, multifidus, and splenius capitis muscles.
The Neck Pain and Disability scale and Beck Depression Inventory scores of the patient group were higher than controls. In the patient group, the total Neck Pain and Disability scale scores were significantly correlated with the pain pressure threshold values of the trapezius and levator scapula muscles and Beck Depression Inventory scores. Regression analyses showed that increased disease duration, decreased pain pressure threshold values of trapezius muscle, unilateral disease and increased Beck Depression Inventory scores were associated with higher disability. Cervical myofascial pain is a reason for disability in chronic neck pain population. Disease duration was found as the strongest predictor of disability.
