Tender point sensitivity, range of motion, and perceived disability in subjects with neck pain

STUDY DESIGN

Descriptive analysis of impairment and disability measures in subjects with neck pain.

OBJECTIVES

To identify discrete tender points and overall pressure sensitivity and assess relationships among palpation tenderness, active cervical range of motion, visual analog scale pain scores, and Sickness Impact Profile disability scores.

BACKGROUND

Palpation tenderness and cervical range of motion are used to evaluate patients with neck pain, but their ability to predict patient-perceived pain and disability is unknown.

METHODS AND MEASURES

We studied 45 women and 15 men with neck pain (mean age, 35 +/- 7 years). Group 1 included 30 persons who had not sought treatment, and group 2 included 30 persons who had just been referred for treatment.

RESULTS

Subjects demonstrated low mean pressure pain thresholds of tender points (2.3 +/- 1.3 kg). Regression analysis showed that only neck flexion predicted pain (R2 = 0.23), with decreased flexion associated with higher pain levels. Sickness Impact Profile total score was predicted by neck rotation (R2 = 0.31), group (R2 = 0.16), tender point pressure pain threshold (R2 = 0.04), and neck retraction (R2 = 0.03). Decreased neck rotation, neck retraction, and pressure pain thresholds were associated with higher disability.

CONCLUSIONS

Neither palpation tenderness nor cervical range of motion were strong predictors of pain and disability in subjects with neck pain.