Neck Pain Assessment Overview - Lemeunier 2018

Exaggerated forward movement of the shoulder blades, often seen in people with neck pain, can improve the consistency of clinical findings.

Tools like specialized rulers, digital calipers, and angle measuring devices don't consistently differentiate neck pain patients from healthy individuals.

A larger angle between the skull and the first vertebra (C1) is linked to greater reported disability in neck pain patients compared to healthy individuals, but not necessarily pain levels.

Examining individual spinal segments (C2-C7) using touch to identify pain in neck pain patients has inconsistent results.

While examining the joints for tenderness has better reliability, assessing muscles through touch is less consistent for detecting neck pain.

Combining the detection of pain with the feeling of stiffness in a specific joint area can increase the validity of assessment.

Neck pain patients with significant psychosocial factors often exhibit tenderness in specific areas of their body, including the temples, neck, and upper back muscles.

Assessing joint movement through touch has limited value in neck pain patients, while combining joint and muscle assessments improves accuracy.

A test measuring how long someone can hold their head in an extended position against a dynamometer. It involves resisting the dynamometer's force by using neck extensor muscles, but avoiding any compensating movements from the neck.

Maximum Voluntary Isometric Contraction. A measurement of someone's maximum force during a static contraction.

The ability to withstand pressure and maintain a position for an extended period without pain. It's especially relevant to chronic conditions where pain responses can be exaggerated.

A state of chronic pain accompanied by an increased sensitivity to pain stimuli even in areas beyond the original source of pain, often associated with chronic neck pain.

A method of treatment involving a combination of physical therapy, medication, and lifestyle modifications, tailored to individual needs. It emphasizes patient engagement and shared decision making.

Exercises specifically targeting the muscles in the neck and shoulder region, often prescribed for pain management and improved function in neck pain.

A type of nerve fiber associated with touch sensation. It is involved in temporal summation, a mechanism that can contribute to increased pain perception.

A type of nerve fiber associated with pain sensation. It's involved in temporal summation, a mechanism that can contribute to increased pain in conditions like chronic neck pain.

A phenomenon where repeated, non-painful stimuli, when delivered at a certain rate, can trigger pain. Common in chronic pain conditions.

Increased sensitivity to pain in response to mechanical pressure (e.g., touch, movement) that is localized within the affected region.

A type of thinking where individuals dwell on the negative aspects of their pain, leading to heightened fear and anxiety.

The belief that avoiding certain movements or activities will protect you from pain, even if it restricts your overall function.

The tendency to engage in behaviors that seem to reduce pain in the short term, but ultimately maintain or worsen the problem long-term.

A state where the nervous system becomes hypersensitive to painful stimuli, leading to amplified pain responses.

Insufficient or poor quality sleep can increase the risk of developing Neck Pain, especially for women.

People between 40 and 69 years old experience the most frequent new cases of neck pain.

Physical activities, work demands, and household chores can all contribute to neck pain.

Changes in the cervical spine's mobility and anatomy can be a cause of neck pain. This includes age-related changes and potential injuries.

The presence of other health conditions, such as musculoskeletal or non-musculoskeletal disorders, can increase the risk of neck pain.

People with limited social or work support are more vulnerable to developing neck pain.

High job demands and being an ex-smoker are also associated with increased risk of neck pain.

Mood disorders, distress, anxiety, and negative emotions are all linked to higher risk and severity of neck pain.

Depression acts as a mediator, connecting pain and disability, while anxiety and PTSD are commonly found alongside neck pain.

Dry needling, a common treatment in many countries, is considered potentially dangerous in Italy, as it primarily provides immediate pain relief without long-term benefits.

Dry needling has been shown to be less effective than manual therapies, like massage or stretching, in the short term. It may provide some immediate pain relief, but its benefits diminish quickly.

Dry needling may offer initial pain relief, but this improvement typically disappears over time. Studies show that the benefits of dry needling do not last, possibly due to lack of lasting muscle changes.

Aerobic training, like swimming, biking, and walking, can benefit those with neck pain and headaches by improving pain levels, function, and overall disability.

While aerobic training shows promise in managing neck pain, there's no definitive guideline on which patients benefit most. This is due to the wide variety of studies and patient populations.

Studies investigating aerobic training for neck pain have focused on diverse patient groups, from those with migraine headaches to those with mechanical neck pain. This makes it difficult to establish clear guidelines.

The types and intensity of aerobic training programs used in different studies varied widely, making it challenging to determine the most effective approach for managing neck pain.

Aerobic exercise can be a valuable tool for managing neck pain and improving function. However, more research is needed to understand how tailored exercise programs can best benefit different patient groups.

Stretching and self-mobilization techniques can be done independently to improve flexibility and range of motion in the neck.

Strengthening exercises targeting the neck muscles can help stabilize the neck and improve overall function. Find a qualified professional to ensure correct form and avoid injury.

Scapular training exercises involve movements that strengthen the muscles around the shoulder blade, such as the upper and middle trapezius, rhomboids, and serratus anterior.

Scapular exercises can be performed with resistance bands or bodyweight, and they are generally considered safe and effective for managing neck pain.

While scapular exercises are often beneficial, the evidence for their effectiveness in reducing neck pain isn't overwhelming, especially for reducing disability.

Neck extensor strengthening exercises involve strengthening the muscles at the back of the neck, which help support the natural curve of the cervical spine.

Neck extensor exercises are considered superior to simple stretching for managing chronic neck pain, as they improve muscle strength and might even increase muscle size.

Deep cervical flexor strengthening involves targeting muscles in the front of the neck that control head movement and support the cervical spine's natural curve.

Deep cervical flexor exercises have been shown to be more effective than conventional exercises for neck pain, improving pain, disability, and overall neck function.

Manual therapy techniques, like Mulligan's mobilization with movement (MWM), aim to restore proper joint movement and reduce pain by addressing underlying mechanical restrictions.

MWM is a self-mobilization technique, meaning patients can perform the exercises themselves, leading to quick improvements in pain and mobility.

Pain neurophysiology education (PNE) is a strategy that helps patients understand the mechanisms of pain, reducing fear and anxiety associated with pain and improving their ability to manage symptoms.

PNE can be used independently or in combination with other treatments, effectively reducing both pain and fear of movement (kinesiophobia).

Cognitive functional therapy (CFT) is a behavioral approach for managing spinal pain, focusing on the physical, psychological, and social factors that contribute to pain and helping patients regain control over their condition.

While CFT is more commonly used for low back pain, research suggests it can be beneficial for chronic neck pain, tackling pain, disability, fear of movement, and negative thinking about pain.

Exercises like strength training, stretching, and balance exercises can reduce the risk of developing neck pain in office workers, especially when done regularly.

Regular exercise, including active breaks and postural shifts, can significantly reduce the risk of new neck pain and low back pain, demonstrating a large effect size.