Neck Pain & Movement Control
Is This Blog About Your Neck Pain?
If you’re someone suffering from neck pain or wondering why it’s uncomfortable to turn your head when your backing your car up, or wondering why your movement and coordination just seems off after suffering a neck injury or whiplash injury. This blog post is for you.
It has been thought by researchers and scientist that one key aspect of neck pain is an issue with controlling the muscles of the neck, especially when it comes to idiopathic neck pain, meaning there isn’t a specific diagnosis that can be pinpointed, and traumatic neck pain, think a whiplash injury.
It’s also thought that this lack of control of the muscles that occurs in neck pain is one of the reasons why up to 10% of individuals who have had a whiplash type injury still have neck pain up to two decades later. While research has continually shown this more research is always needed to confirm past findings. When more and more research continues to get published on a certain topic another group of researchers will perform a systematic review.
A systematic review is taking a ton of studies that have been done on a topic, like neck pain and motor control, and then going through the research, reviewing the findings, and looking at what the differences and similarities are and if there are any conclusions that can be confirmed or possible new ideas to come from looking at the bulk of the research.
Well thats exactly what researchers, Franov, Straub, Bauer, and Ernst did in their most recent paper titled, “Head kinematics in patients with neck pain compared to asymptomatic controls: a systematic review” What the researchers did was search through a wide range of research databases on papers related to the subject of neck pain and movement control. They then did a quality assessment and risk of bias analysis to determine the quality and bias of the papers. They then extracted the data from the research including information on sampling procedures, sample sizes, participant data, measurement methods, outcome variables and risk of bias and summarized the outcomes variables across the studies. They started with 870 studies but by the end of it only 27 studies were deemed high enough quality to be included in the review on neck pain and movement control.
“Head Kinematics In Patients With Neck Pain Compared To Asymptomatic Controls: A Systematic Review”
Let’s dive into what these researchers found on neck pain and movement control.
In total there were 1847 people involved in the studies on neck pain and movement control, of those 911 were healthy controls and they healthy controls would be compared to those with pain to see how they were different. Of the remaining individuals 631 had idiopathic neck pain and 305 had neck pain brought on by a traumatic injury(whiplash). The age of the individuals ranged from 25 to 51 years old.
One of the things that we look at at our office is neck disability index, 1-100 rating of pain, and VAS (Visual Analogue Scale), essentially all three of these are different ways to rank your pain. This is an easy subjective way to track progress and also get a baseline of where someone in pain is at during their initial visit and throughout care. This type of subjective assessment for neck pain is commonly used and were some of the metrics looked at in the research review.
Here’s what they found. In the individuals with neck pain the average pain intensity, as measured on a 0 to 100 measurement scale ranged from 20.1 to 60.0 for participants with idiopathic neck pain and from 29.0 to 66.1 for participants with a traumatic neck injury(whiplash injury), likewise average disability, if provided, ranged from 9.5 to 37% for participants with idiopathic neck pain and from 25.2 to 45% for participants with a whiplash injury.
In these studies they looked at head aiming, head tracking, and head pointing. During head-aiming tasks, participants wore a head- mounted device that projected a visible point on a screen or wall in front of them. They controlled the position of that signal by moving their head either accurately along a trajectory (tracking) or towards a target point (pointing). These target points and trajectory paths were either visible before and during the tasks (predictable) or appeared unpredictably (unpredictable). Three studies examined head movement and control while participants performed functional tasks, such as driving in a simulator, catching a ball, or lifting a weight and different test were used in relation to speed, repetitions, or the amplitude of movement.
Essentially the researchers looked at a lot of different ways to move the head in individuals with neck pain either idiopathic or from a whiplash injury and compared them to those who had no neck pain.
Movement Control In A Healthy Neck vs A Neck In Pain
Here’s what they found. First individuals with neck pain aren’t able to move their head and neck at a normal speed.
What would this look like?
Imagine trying to back out of a driveway, or backing up to pull out of a parallel parking spot, but when you go to turn your head the moment feels slow or abnormal, like you don’t have full control of the movement. This suggest that not only do individuals with neck pain have discomfort but also that their motor response substantially slows down during movement activities.
Individuals with neck pain were also found to have less accuracy when moving their head and neck. Meaning that if you were to close your eyes and look straight ahead and then we had you turn your head and come back to the middle, you wouldn’t be able to find middle, in fact, each time you tried this your middle or center would be different. This decrease in accuracy results in other muscles having to fire to try and find middle leading to over-firing and more pain and fatigue.
Lastly, individuals with neck pain also had slower reaction times when moving their neck and inaccuracy during quick movements. Think of playing catch with a baseball and someone throws you the ball and you have to turn your head to watch the ball go over your shoulder as it goes into the glove, well individuals with neck pain are more likely to not have the ability to turn their head accurately and catch the ball.
What’s This Mean For Someone With Neck Pain?
When it comes to neck pain it isn’t just pain. Neck pain affects our function, our ability to move, and our ability to enjoy the things we like to do.
Luckily, neck pain is solvable and we know that through accurate assessment we can find the underlying issues causing neck pain and then work to restore the movement and function of the neck resulting in a decrease of pain and an improvement of function, aka being able to catch the baseball while turning your head without pain.
While 30-50% of the population has had or will have neck pain, neck pain it isn’t a life sentence and it doesn’t have to be your normal. Reteaching the muscles how to coordinate moment and relieving the tension on the muscle and surrounding tissues can have drastic impacts on improving pain and function of the neck. That’s what we do at Optimize Chiropractic. Find out if we can help you by clicking below to schedule your complimentary consultation.
I hope you enjoyed this blogged, learned a little bit more about the neck, and as always if you have any questions please reach out to me at drcoffman@optimizecolumbus.com
References
Franov E, Straub M, Bauer CM, Ernst MJ. Head kinematics in patients with neck pain compared to asymptomatic controls: a systematic review. BMC Musculoskelet Disord. 2022 Feb 16;23(1):156. doi: 10.1186/s12891-022-05097-z. Erratum in: BMC Musculoskelet Disord. 2022 May 24;23(1):492. PMID: 35172799; PMCID: PMC8848642.