Myofascial Trigger Points and Postero-Anterior Joint Hypomobility in the Mid-Cervical Spine in Subjects Presenting with Mechanical Neck Pain: A Pilot Study

Abstract

A relationship between muscle and joint impairments has been proposed in the literature; however, the prevalence and the extent of a possible correlation between these disorders in a patient population with mechanical neck pain have been documented in only a few papers. Our aims for this cross-sectional study were to assess the prevalence of myofascial trigger points (TrPs) in the upper trapezius, sternocleidomastoid, and levators capulae muscles; the prevalence of posterior-anterior (PA) joint hypomobility in the mid-cervical spine (C3-C6); and the correlation of these impairments in patients presenting with mechanical neck pain. Thirty patients with neck pain were examined for the presence of TrPs, according to the diagnostic criteria described by Simons et al and Gerwin et al, and for the presence of mid-cervical spine join thypomobility as described by Maitland. One clinician first examined for TrPs. A second clinician blinded to the TrP results then examined the patients for PA joint hypomobility. All patients exhibited TrPs. The mean number of TrPs present on each patient was 3.4 (SD±0.9), of which 2.4 (±1.3) were latent and 1.1 (±0.9) were active. PA joint hypomobility was the most prevalent at the C3 vertebra (24 patients or 80%), followed by joint hypomobility at the C4 vertebra (6 subjects or 20%). The relationship between TrPs and cervical PA joint hypomobility did not reach significance (P>0.1). We conclude that all patients with mechanical neck pain exhibited PA joint hypomobility of the mid-cervical spine and TrPs in the cervical musculature. However, correlation between these findings was not statistically significant.

Keywords:

• MECHANICAL NECK PAIN
• MYOFASCIAL TRIGGER POINTS
• ZYGAPOPHYSEAL JOINT
• PASSIVE ACCESSORY INTERVERTEBRAL MOTION