Institutional members access full text with Ovid®

Share this article on:

Association between Clinical and Neurophysiological Outcomes in Patients with Mechanical Neck Pain and Whiplash-associated Disorders

Castaldo, Matteo PT; Catena, Antonella PT; Chiarotto, Alessandro PT, MSc; Villafañe, Jorge Hugo PT, PhD, MSc, PT; Fernández-de-las-Peñas, César PT, PhD, Dr. Med. Sci; Arendt-Nielsen, Lars PhD, Dr. Med. Sci.
The Clinical Journal of Pain: Post Acceptance: July 03, 2017
doi: 10.1097/AJP.0000000000000532
Original Article: PDF Only


To investigate the association between pain, disability, trigger points (TrPs) and pressure pain thresholds (PPTs) in patients with mechanical (MNP) or whiplash-associated disorders (WAD).


Forty-six MNP and fifty-one WAD patients underwent a physical examination consisting of cervical range of motion, PPTs in the upper trapezius and tibialis anterior muscles, TrPs examination in the upper trapezius, and collection of clinical data including disability, pain intensity and spontaneous symptomatic pain area.


A significantly moderate positive association between pain and disability was found in both groups (P<0.01). Significantly negative associations between pain intensity and PPT in the upper trapezius (P=0.008 and P=0.041), pain and PPT in tibialis anterior (P=0.015 and P=0.038),disability and PPT in upper trapezius (both, P=0.006) were also found in both MNP and WAD groups. Individuals with MNP showed significantly positive association between pain area and disability (P=0.034) and negative association between disability and PPT in the tibialis anterior (P=0.003). Patients with active TrPs in the upper trapezius exhibited higher intensity of neck pain, higher neck disability and lower PPTs than those with latent TrPs in upper trapezius in both groups.


The association between pain, disability, and PPTs is common in subjects with neck pain regardless of the origin of neck pain. The presence of active TrPs was related to higher pain intensity and related-disability and lower PPTs.

Source of Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflicts of Interest: No conflicts of interests to declare.

Reprints: Lars Arendt-Nielsen, PhD, Dr. Med. Sci., SMI®, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Fredrik Bajers Vej 7D3, DK-9200 Aalborg, Denmark (e-mail:

Received December 15, 2016

Accepted June 16, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.