Effects of deep cervical flexor training on pressure pain thresholds over myofascial trigger points in patients with chronic neck pain

J Manipulative Physiol Ther. 2013 Nov-Dec;36(9):604-11. doi: 10.1016/j.jmpt.2013.08.004. Epub 2013 Oct 21.

Abstract

Objective: The purpose of this study was to assess the effects of a low-load training program for the deep cervical flexors (DCFs) on pain, disability, and pressure pain threshold (PPT) over cervical myofascial trigger points (MTrPs) in patients with chronic neck pain.

Methods: Thirty patients with chronic idiopathic neck pain participated in a 6-week program of specific training for the DCF, which consisted of active craniocervical flexion performed twice per day (10-20 minutes) for the duration of the trial. Perceived pain and disability (Neck Disability Index, 0-50) and PPT over MTrPs of the upper trapezius, levator scapulae, and splenius capitis muscles were measured at the beginning and end of the training period.

Results: After completion of training, there was a significant reduction in Neck Disability Index values (before, 18.2 ± 12.1; after, 13.5 ± 10.6; P < .01). However, no significant changes in PPT were observed over the MTrPs.

Conclusion: Patients performing DCF training for 6 weeks demonstrated reductions in pain and disability but did not show changes in pressure pain sensitivity over MTrPs in the splenius capitis, levator scapulae, or upper trapezius muscles.

Keywords: Exercise; Neck Muscles; Neck Pain; Trigger Points.

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Chronic Pain
  • Cohort Studies
  • Facial Neuralgia / diagnosis
  • Facial Neuralgia / rehabilitation*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Manipulation, Spinal / methods
  • Massage / methods*
  • Middle Aged
  • Neck Muscles / physiopathology*
  • Neck Pain / diagnosis
  • Neck Pain / rehabilitation*
  • Pain Measurement
  • Prospective Studies
  • Sensory Thresholds / physiology
  • Severity of Illness Index
  • Treatment Outcome
  • Trigger Points*
  • Young Adult