Population based cross-sectional study
The aim of this study was to gain a better understanding of changes in muscle morphology in patients with chronic idiopathic neck pain (CINP) and whiplash associated disorder (CWAD).
Summary of Background Data.
Worldwide, neck pain is a common health problem with high socio-economic burden. A high percentage of these patients evolves towards chronic symptoms. Efficacy of treatments for these complaints remains variable. In current literature, changes in muscle morphology (muscle fatty infiltration [FI] and cross-sectional area [CSA]) have been reported in neck pain patients, both CWAD and CINP. However, no strong conclusions could be made.
In this study, magnetic resonance imaging was used to obtain data on muscle morphology from 14 cervical flexor and extensor muscles in 118 female subjects with neck pain (CWAD = 37; CINP = 45) and healthy controls (HC = 35).
The CWAD group had a significantly larger muscle FI in some extensor (Semispinalis and Splenius Capitis, Trapezius, Obliquus Capitis Inferior) and flexor (Sternocleidomastoid) muscles compared to the CINP and/or HC group. A significant larger (muscle) CSA was found in some extensor (Levator Scapulae, Semispinalis Capitis, Trapezius) and flexor (Longus Colli, Longus Capitis, Sternocleidomastoid) muscles in the HC group compared to the CINP and/or CWAD group. No clear associations were found between group differences and factors as pain duration, kinesiophobia and disability.
The results in this study suggest changes in muscle morphology in both neck pain cohorts. These results show some similarities with earlier findings in this research domain. Further studies based on controlled longitudinal designs are needed to facilitate data compilation, to draw stronger conclusions and to integrate them into the treatment of chronic neck pain patients.
Level of Evidence: 4