Neck Muscle Stiffness Measured With Shear Wave Elastography in Women With Chronic Nonspecific Neck Pain

J Orthop Sports Phys Ther. 2020 Apr;50(4):179-188. doi: 10.2519/jospt.2020.8821. Epub 2020 Jan 6.


Objective: Utilizing shear wave elastography, we compared the stiffness of the neck extensor muscles and the stiffness in muscle-specific regions between women with chronic nonspecific neck pain and asymptomatic controls.

Design: Cross-sectional observational study.

Methods: We measured the average muscle stiffness over multiple neck extensor muscles and in regions corresponding approximately to the trapezius, splenius capitis, semispinalis capitis, semispinalis cervicis, and multifidus muscles using ultrasound shear wave elastography in 20 women with chronic nonspecific neck pain and 18 asymptomatic women during multiple tasks. The measurements were automatically quality controlled and computer processed over the complete visible neck region or a large muscle-specific region.

Results: Pooled over all tasks, neck muscle stiffness was not significantly different between those with neck pain and asymptomatic controls (neck pain median, 11.6 kPa; interquartile range, 8.9 kPa and control median, 13.3 kPa; interquartile range, 8.6 kPa; P = .175). The measure of neck muscle stiffness was not correlated with the intensity of neck pain or perceived disability.

Conclusion: Shear wave elastography revealed similar muscle stiffness in people with and without chronic neck pain, despite the sensation of increased neck stiffness in those with chronic neck pain. Therapeutic interventions aiming to reduce neck muscle tone are often based on the assumption that perceived neck stiffness corresponds to objective muscle stiffness. The current results question this assumption. J Orthop Sports Phys Ther 2020;50(4):179-188. Epub 6 Jan 2020. doi:10.2519/jospt.2020.8821.

Keywords: cervical spine; chronic pain; muscle tension; shear modulus; ultrasound shear wave elastography.

Publication types

  • Observational Study

MeSH terms

  • Chronic Pain / diagnostic imaging*
  • Chronic Pain / physiopathology
  • Chronic Pain / therapy
  • Cross-Sectional Studies
  • Elasticity Imaging Techniques*
  • Female
  • Humans
  • Middle Aged
  • Muscle Tonus*
  • Neck Muscles / diagnostic imaging*
  • Neck Muscles / physiopathology
  • Neck Pain / diagnostic imaging*
  • Neck Pain / physiopathology
  • Neck Pain / therapy
  • Physical Therapy Modalities