Factors Associated with Neck and Shoulder Pain in Volunteers

Incidence of Cervical Kyphosis and Factors Associated with Improvement in Postoperative Cervical Spinal Alignment in Idiopathic Scoliosis with Major Thoracolumbar/Lumbar and Thoracic Curves

Background: This study aimed to compare the incidence and severity of cervical kyphosis before and after surgery between patients with adolescent idiopathic scoliosis (AIS) with major thoracolumbar/lumbar curves (Lenke type 5C group) and those with major thoracic curves (Lenke type 1A group). Further, factors associated with cervical spinal alignment changes after surgery in the two groups were examined. Methods: This study included consecutive patients with AIS who underwent posterior spinal fusion for Lenke type 1A and 5C curves and who were followed up for at least 1 year. To measure changes in sagittal alignment, all patients underwent radiography before, immediately after, and at 1 year after surgery. The correlation coefficients change the value of the C2-C7 angle before and after surgery (ΔC2-ΔC7) and other spinopelvic parameters were examined. Results: In total, 19 of 30 patients in the Lenke type 1A group and 21 of 36 in the Lenke type 5C group presented with cervical kyphosis preoperatively. Hence, the incidence of cervical kyphosis did not significantly differ between the two groups. Further, the two groups had significantly higher thoracic kyphosis (TK) and greater C2-C7 angles postoperatively. The TK of the Lenke type 5C group further increased at 1 year postoperatively. The Lenke 1A type group presented with a significant re-decrease in the C2-C7 angle at 1 year postoperatively. However, the C2-C7 angle of the Lenke type 5C group did not change. The ΔTK was closely associated with the ΔC2-ΔC7 in the Lenke type 1A group, but not in the Lenke type 5C group. Conclusions: In thoracic AIS, postoperative cervical alignment should achieve an adequate TK and promote correction of the coronal plane curve. Moreover, selective corrective surgery can improve postoperative cervical alignment in lumbar AIS.

Neck and shoulder pain in thoracic adolescent idiopathic scoliosis 10 years after posterior spinal fusion

PURPOSE

We aimed to determine the clinical significance of neck and shoulder pain (NSP) 10 years after posterior spinal fusion (PSF) for thoracic adolescent idiopathic scoliosis (AIS) and the relationship between radiographic parameters and NSP.

METHODS

Of 72 patients who underwent PSF for thoracic AIS (Lenke 1 or 2) between 2000 and 2013, we included 52 (46 females; Lenke type 1 in 34 patients and type 2 in 18; mean age, 25.6 years) who underwent NSP evaluation using visual analog scale (VAS, 10 cm) 10 years postoperatively (follow-up rate, 72.2%). Correlation analyses were performed using Spearman's rank correlation coefficient (r).

RESULTS

The VAS for NSP was 2.6 cm in median and 3.4 cm in mean at 10 years. The VAS had significant negative correlations with several SRS-22 domain scores (rs = - 0.348 for pain, - 0.347 for function,  -  0.308 for mental health, and - 0.372 for total) (p < 0.05). In addition, the VAS score was significantly correlated with cervical lordosis (CL) (rs = 0.296), lumbar lordosis (rs = - 0.299), and sacral slope (rs = 0.362) (p < 0.05). Furthermore, at the 10-year follow-up, CL was significantly negatively correlated with T1 slope (rs = - 0.763) and thoracic kyphosis (TK) (- 0.554 for T1-12 and - 0.344 for T5-12) (p < 0.02).

CONCLUSION

NSP was associated with deterioration in SRS-22 scores, indicating that NSP is a clinically significant long-term issue in PSF for thoracic AIS. Restoring or maintaining the TK and T1 slopes, which are controllable factors during PSF, may improve cervical lordosis and alleviate NSP at 10-year follow-up.

Prevalence and risk factors of occupational neck pain in Chinese male fighter pilots: a cross-sectional study based on questionnaire and cervical sagittal alignment

Background

Neck pain (NP) is a common musculoskeletal disorder among fighter pilots and has become a rising concern due to its detrimental impact on military combat effectiveness. The occurrence of NP is influenced by a variety of factors, but less attention has been paid to the association of NP with demographic, occupational, and cervical sagittal characteristics in this group. This study aimed to investigate the prevalence and risk factors of NP in Chinese male fighter pilots using a questionnaire and cervical sagittal measurements.

Methods

Demographic and flight-related data, as well as musculoskeletal pain information, were gathered from Chinese male fighter pilots via a self-report questionnaire. Cervical sagittal parameters were measured and subtypes were classified using standardized lateral cervical radiographs. Differences in various factors between the case and control groups were analyzed using t-tests or chi-square tests. Binary logistic regressions were conducted to explore potential risk factors contributing to NP. Predictors were presented as crude odds ratios (CORs) and adjusted odds ratios (AORs), along with their respective 95% confidence intervals (CIs).

Results

A total of 185 male fighter pilots were included in this cross-sectional study. Among them, 96 (51.9%) reported experiencing NP within the previous 12 months. The multivariate regression analysis revealed that continuous flight training (AOR: 4.695, 95% CI: 2.226-9.901, p < 0.001), shoulder pain (AOR: 11.891, 95% CI: 4.671-30.268, p < 0.001), and low back pain (AOR: 3.452, 95% CI: 1.600-7.446, p = 0.002) were significantly associated with NP.

Conclusion

The high 12-month prevalence of NP among Chinese male fighter pilots confirms the existence of this growing problem. Continuous flight training, shoulder pain, and low back pain have significant negative effects on pilots' neck health. Effective strategies are necessary to establish appropriate training schedules to reduce NP, and a more holistic perspective on musculoskeletal protection is needed. Given that spinal integrated balance and compensatory mechanisms may maintain individuals in a subclinical state, predicting the incidence of NP in fighter pilots based solely on sagittal characteristics in the cervical region may be inadequate.

Effects of gentle mechanical skin stimulation on subjective symptoms and joint range of motions in people with chronic neck and shoulder discomfort

This study aimed to examine the efficacy of a 2-week self-administered gentle mechanical skin stimulation on chronic neck and shoulder discomfort. In participants (n = 12) with chronic neck and shoulder discomfort, subjective measures of pain sensation, discomfort, and difficulty in moving using a visual analog scale (VAS, 0-10) and objective measures of 12 different joint range of motions (ROMs) for the cervical and shoulder regions, using a digital goniometer, were collected before and after self-care with contact acupuncture, called microcones. The self-care for 2 weeks significantly (p < 0.001) decreased all VAS scores to 2.2-2.3 from baseline values of 6.0-7.4. Of the 12 ROMs tested, 8 were significantly increased (p < 0.013). This open-label study suggests the use of self-care with microcones in improving subjective symptoms and joint ROMs in people suffering from chronic neck and shoulder discomfort. However, a randomized, double-blind, controlled clinical trial is needed to further investigate the efficacy and safety of microcones.

Neck Pain and Related Factors in Patients with Rheumatoid Arthritis

OBJECTIVES

In rheumatoid arthritis, neck pain can be caused by inflammatory reactions or cervical lesions, but the prevalence and associated factors have not been well studied. This study aimed to investigate the prevalence of neck pain in patients with rheumatoid arthritis and elucidate the related factors.

METHODS

This study included 146 patients with rheumatoid arthritis. Neck pain, quality of life, and levels of anxiety and depression were evaluated using a questionnaire. Cervical lesions and spinal alignment were evaluated using plain radiograph and magnetic resonance imaging. Factors associated with neck pain were analysed using a logistic regression model.

RESULTS

Fifty-six percent of the patients had neck pain, and the quality of life scores were significantly worse in these patients. Multivariate analysis revealed age, C7 sagittal vertical axis (SVA), upper cervical lesion, and endplate erosion as factors associated with neck pain in patients with rheumatoid arthritis.

CONCLUSIONS

More than half the patients with rheumatoid arthritis suffer from neck pain, and neck pain affects the quality of life and activities of daily living. Neck pain was associated with upper cervical lesion and endplate erosion suggesting the importance of radiological examination in patients with rheumatoid arthritis and neck pain.