Results of a self-management program added to standard physical therapy in chronic neck pain

2020 ◽  
Author(s):  
L. López-López ◽  
M.J. Ariza-Mateos ◽  
J. Rodríguez-Torres ◽  
I. Cabrera-Martos ◽  
M. Granados-Santiago ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Chronic Neck Pain ◽  
Management Program ◽  
Self Management

Enhanced Pronociceptive and Disrupted Antinociceptive Mechanisms in Nonspecific Chronic Neck Pain

2020 ◽  
Author(s):  
Josu Zabala Mata ◽  
Ion Lascurain-Aguirrebeña ◽  
Estíbaliz Dominguez López ◽  
Jon Jatsu Azkue
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Tibialis Anterior ◽  
Chronic Neck Pain ◽  
Pain Modulation ◽  
Mean Difference ◽  
Central Pain ◽  
Nociceptive Processing ◽  
Antinociceptive Mechanisms ◽  
Second Pain

Abstract Objective Evidence suggests altered pronociceptive and antinociceptive mechanisms in many chronic pain conditions. Knowledge about these mechanisms in nonspecific chronic neck pain (NSNP) would improve understanding of the causes and the design of more effective treatments. Pressure pain threshold (PPT) is often used to assess presence of altered nociceptive processing in NSNP; however, its usefulness to detect this is yet to be established. The purpose of this study was to determine the functional status of temporal summation of second pain (TSSP) and conditioned pain modulation (CPM) in NSNP and to characterize the association of both measures with PPT and clinical features of NSNP. Methods Thirty-two participants with NSNP (mean [SD] age = 44 [11] y; 27 female) and 32 age and sex matched healthy controls were recruited. TSSP was assessed using an electrical stimulus at the dorsum of the hand, and CPM was evaluated with the Cold Pressor Test. PPT was assessed bilaterally at the neck and tibialis anterior muscles. Results Participants with NSNP showed greater TSPP (mean difference = 0.23; 95% CI = 0.46-0.01; Cohen d = 0.51) and lower CPM (mean difference = 19.44; 95% CI = 10.42-28.46; Cohen d = 1.09). Pooled data from all participants showed lower PPTs at the neck than the tibialis anterior. However, PPT measures did not differ between groups at either location. PPT measures were not correlated with CPM and TSP. Conclusion NSNP is associated with enhanced pronociceptive and impaired antinociceptive mechanisms, which may explain long-lasting pain and failure of some treatments to resolve symptoms. However, due to the observational nature of this study, a clear cause-effect relationship cannot be established. Normal PPT values in the clinic should not be interpreted as absence of altered nociceptive processing. Impact This study fills in some gaps in knowledge. Changes in central nociceptive processing may explain persistent and recurrent symptoms in NSNP and failure of treatments to obtain long-lasting relief. Further research is required to ascertain if TSSP and CPM assessment in the clinic may help predict physical therapy treatment outcome. Whether symptomatic relief with physical therapy is mediated by an improvement in TSSP and CPM should also be explored. PPTs were unaltered in participants with NSNP despite evidence of impairment in the central pain modulatory systems. Normal PPTs should not be interpreted as evidence of unaltered central pain-related processing.

scholarly journals Stress Management as an Adjunct to Physical Therapy for Chronic Neck Pain

2012 ◽  
Vol 92 (10) ◽  
pp. 1348-1359 ◽  
Author(s):  
Angela K. Bruflat ◽  
Jaclyn E. Balter ◽  
Denise McGuire ◽  
Nathan B. Fethke ◽  
Katrina S. Maluf
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Stress Management ◽  
Muscle Activity ◽  
Psychosocial Stress ◽  
Muscle Relaxation ◽  
Trapezius Muscle ◽  
Chronic Neck Pain ◽  
Multidisciplinary Intervention ◽  
Neck Disability

Background and Purpose Chronic neck pain is prevalent in the workplace. Research suggests that psychosocial stress may contribute to the development of neck pain by causing excessive or prolonged muscle activity in some individuals. The purpose of this case report is to describe the rationale, development, and implementation of stress management as an adjunct to standard physical therapist management of chronic neck pain in a female office worker who responded to psychosocial stress with elevated muscle activity prior to treatment. Case Description A 44-year-old female office employee with an 8-year history of chronic neck pain participated in this case report. The patient was selected from a group of research participants who demonstrated elevated electromyographic (EMG) activity of the trapezius muscle in response to simulated occupational stressors. The multidisciplinary intervention consisted of 8 physical therapy sessions, supplemented by 8 stress management sessions that included EMG biofeedback and psychotherapy to facilitate muscle relaxation. Outcomes Neck disability decreased by 50%, trait anxiety decreased by 21%, and the duration of trapezius muscle rest in the workplace increased by 56% immediately after the 8-week intervention. These improvements were maintained 6 months after treatment, and the patient reported a complete absence of neck disability at the 2-year follow-up assessment. Discussion A sustained reduction in neck disability was observed for a patient with chronic neck pain after participating in a multidisciplinary intervention that combined physical therapy and stress management approaches to facilitate muscle relaxation in the workplace. Future clinical trials are needed to assess whether stress management is a useful adjunct therapy for patients with chronic neck pain who show elevated muscle activity in response to psychosocial stress.

scholarly journals Effectiveness and safety of polydioxanone thread embedding acupuncture compared to physical therapy in the treatment of patients with non-specific chronic neck pain

Medicine ◽  
2019 ◽  
Vol 98 (32) ◽  
pp. e16768
Author(s):  
Jae Ik Kim ◽  
Young Il Kim ◽  
Eunseok Kim ◽  
Ju Hyun Jeon ◽  
Jin Youp Kim ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Chronic Neck Pain

scholarly journals A Comparative Study of the Effectiveness of Pharmacopuncture Therapy for Chronic Neck Pain: A Pragmatic, Randomized, Controlled Trial

2021 ◽  
Vol 11 (1) ◽  
pp. 12
Author(s):  
Kyoung-Sun Park ◽  
Suna Kim ◽  
Changnyun Kim ◽  
Ji-Yeon Seo ◽  
Hyunwoo Cho ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Physical Therapy ◽  
Neck Pain ◽  
Therapy Group ◽  
Controlled Trial ◽  
Chronic Neck Pain ◽  
Arm Pain ◽  
Randomized Controlled ◽  
Vas Score

Background: This two-arm, parallel, pragmatic, multicenter, clinical randomized, controlled trial with a 12-week follow-up period aimed to compare the effectiveness of pharmacopuncture therapy and physical therapy strategies for chronic neck pain. Methods: Eight sessions of pharmacopuncture therapy or physical therapy were administered within 2 weeks. The primary outcome was the visual analogue scale (VAS) score for neck pain. The secondary outcomes were the scores of the Northwick Park questionnaire (NPQ), VAS score for radiating arm pain, numeric rating scale (NRS) for neck and arm bothersomeness, neck disability index (NDI), patient global impression of change (PGIC), 12-item short form health survey (SF-12), and EuroQoL 5-dimension 5-level (EQ-5D-5L) instrument. The protocol was registered with Clinicaltrials.gov (NCT04035018) and CRIS (KCT0004243). Results: We randomly allocated 101 participants with chronic neck pain to the pharmacopuncture therapy (n = 50) or physical therapy group (n = 51). At the primary endpoint (week 5) the pharmacopuncture therapy group showed significantly superior effects regarding VAS score for neck pain and arm bothersomeness, NRS for neck pain, NDI, NPQ, and PGIC compared with the physical therapy group. These effects were sustained up to 12 weeks after follow-up. Conclusion: Compared with physical therapy, pharmacopuncture therapy had superior effects on the pain and functional recovery of patients with chronic neck pain.

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