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A Comparison of Two Helpful Exercises for Chronic Neck Pain Reduction

Posted on: 03/10/2016
The human neck is an amazing series of joints that allow the head to rotate, flex and side bend with very little effort or training. These simple motions typically give us easy access to perform daily activities like eating, driving, reading and washing our hair. These basic daily motions can get quite challenging when the neck is in pain or not moving well from an injury, age or various disease processes. Neck pain lasting longer than three months affects up to 31 per cent of the adult population worldwide. Chronic neck pain thus creates a large medical cost on our healthcare system to treat and a significant financial burden for those that have it. There is a lot of research on the topic of effective treatments for chronic neck pain, but the search continues on which treatments get the best results.

Dr. Izquierdo, a physical therapist with a PhD and his team of researchers at the University of Valencia in Spain set about to find which exercises for chronic neck pain are the most helpful. Their area of interest was in the complex nerve and muscle relays that get disturbed in the neck when it has been injured or in pain for a prolonged period. The system of nerve and muscle relays that sense the different positions of the neck joints are called the “cervical proprioceptors“. If you close your eyes and rotate your head to the left, your cervical proprioceptors are part of the sensation message telling your brain your head is rotated left. The neck also has many layers of muscles to support and move the head on your body. A deep group of neck muscles that flex and stabilize the neck’s posture is known as the “deep neck flexors“. Izquierdo’s research team investigated 28 subjects with chronic neck pain (CNP) and randomly assigned them to one of two different physical therapy exercises groups over two months. One group with CNP did exercises to improve cervical proprioception and the second did exercises to improve their deep neck flexor strength. Both training groups did additional independent daily home exercises, as well as their assigned physical therapy grouping exercises.

Results of this study were promising, as they found significant improvements in both groups after two months of neck exercises in their performance on a neck flexion strength index. Further statistics on these improvements did not find differences between the either of the two exercise groups for neck flexion strength. Both exercise groups were also effective in reducing neck pain levels at rest and reducing disability scores after two months.

These results can be applied as effective techniques in the physical therapy clinic, as specific training of the cervical proprioceptors improves both the unpleasant feeling of neck pain and reduces the impacts of neck pain on daily activities. Moreover, both sets of exercises had additional positive effects on other aspects of neck control and function, such as coordinating the contraction of the many layers of neck flexor muscles. Thus training protocols such as those used in this study to improve neck flexor strength and proprioception should be utilized in the clinic for optimizing neck pain and disability reduction.

Izquierdo, TA. et al. Comparison of cranio-cervical flexion training versus cervical proprioception training in patients with chronic neck pain: A randomized controlled clinical trial. In: Journal of Rehabilitative Medicine. 2016; 48: Pp. 48–55

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