Physical fitness should be considered in chronic neck pain management

By Lucy Piper, Senior medwireNews Reporter

Researchers recommend that clinicians consider whole body physical fitness, anxiety and depression when determining strategies for illness management in men and women with chronic neck pain (CNP).

They found that these parameters were significantly impaired in patients with CNP and the effects differed between men and women.

The results, published in the International Journal of Rheumatic Diseases, point to the benefits of aerobic exercise therapies for male patients with CNP and whole body strengthening in addition to neck muscle strengthening for female CNP patients.

A total of 80 patients with CNP and 80 individuals without participated in the study, with an even distribution of men and women in each group. The men with CNP scored an average of 25.1 on the Neck Disability Index (NDI), while the women scored 30.8.

Women with CNP performed significantly worse than controls on handgrip (right hand=22.2 vs 25.8 kg) and back-leg strength (40.7 vs 50.8 kg) tests and they had significantly lower pressure pain detection thresholds in the suboccipital (4.2 vs 4.9 kg) and paraspinal-C7 (4.6 vs 5.5) sites. These parameters were also significantly correlated.

This suggests the need for muscle strengthening to include the whole body and not just the neck, say the researchers, adding: “Accordingly, new strategies for strength training in patients with CNP should be supported by healthcare professionals.”

Sleep quality, measured using the Pittsburg Sleep Quality Index (PSQI), was also affected in the female patients, compared with controls, and they had significantly worse scores on the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Short Form Heath Survey (SF-36) for health-related quality of life.

For men with CNP, the greatest impairments were seen in aerobic exercise capacity, adiposity and sleep quality. They had a VO₂max of 2.1 versus 2.4 L/min and 26.2 versus 29.2 mL/kg per minute, compared with controls, a mean body fat percentage of 37.6 versus 34.2 and a PSQI score of 6.2 versus 4.4.

Researcher Hatice Yalcinkaya (Afyon Kocatepe University, Turkey) and colleagues note that men with CNP had a lower daily step number than controls, albeit not significantly so. They believe that this may cause low VO₂max and high body fat percentage over the long term in these patients, and highlight the need to improve cardiorespiratory fitness.

They conclude that consideration of “whole body physical fitness, anxiety and depression parameters, on the basis of gender, in patients with CNP, might be helpful for the development of more beneficial illness management strategies.”

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