Chronic Neck Pain and Neck Muscle Strength

INTRODUCTION: Neck pain is one of the most common musculoskeletal disorders, with an estimated 1-year prevalence of 31.4% to 35.6% of adults in the general population. The course of neck pain is characterized by exacerbations and remissions and only a small part of the patients experience complete resolution of their symptoms within 1 year. A substantial proportion of the neck pain patients will thus develop chronic neck pain. The definition of chronic pain differs between studies, in terms of either 3 or 6 months duration of complaints. Nevertheless, the estimates of their one year prevalence in the general population are similar: 8.7% to 17.8% for the 3-months definition, and 8% to 13.8% for the 6-months definition. OBJECTIVES: There is not much scientific evidence to support the standard treatments of neck pain (including things like hot and cold packs, ultrasound and massage.) The aim of this study is to assess the neck muscle strength in chronic neck pain patients and in control group and compare the difference in these two groups. This study will give an idea of the difference if at all present in neck muscle strength in these two groups. This also may give an indication of the necessity to improve the neck muscles in the neck pain group. MATERIAL AND METHOD: In this study we assessed the cervical spine muscle strength in persons with chronic neck pain and in control group without history of neck pain. With this data the strength of the neck muscles are compared and the difference in muscle strength is found out. SELECTION OF THE SUBJECTS: It is well known that the acute pain inhibits the muscle contraction. In this study only patient who is totally pain free is taken up for the study. These are the patients who have chronic pain for more than six months and they are in remission during the evaluation. They should not have any organic lesion, fracture, infection, post operative problems. From all the persons consent to join in the study is received. METHODOLOGY: Isometric neck muscle strength is assessed in sitting posture. A spring balance [Pic – 6] was mounted on a stand and the height is fixed. According to the height of the subject the stool height is adjusted. SUMMARY: • Neck muscles are weaker in Chronic Neck Pain patients. • Neck extensors are more than two times stronger than flexors. • In the control group the neck muscles are stronger in the active group. The sedentary people in the control group have weaker muscles. • The lateral flexors are stronger on the left side. CONCLUSION: 1. In Chronic Neck Pain patients due to their weak neck muscles the protection to the cervical spine is less to prevent further injury during stressful situations. So they require regular and specific neck muscle strengthening exercise to prevent recurrence of symptom. These specific cervical exercises strengthen the spinal muscles and provide better support by spinal bracing. 2. The role of cervical brace is also important. They may be used in situations where the person with chronic neck pain is subjected to prolonged stresses as in occupation or while traveling. 3. The sedentary people in the control group were found to have weaker muscles. Are they prone to neck pain? Only long term study can prove this aspect of finding. Follow up - All the Chronic Neck Pain patients were given a program of exercise. The neck pain feed back form is also given to them. Follow up in future will confirm the usefulness of the exercise in preventing frequent recurrences.