An investigation of sagittal thoracic spinal curvature and mobility in subjects with and without chronic neck pain: cut-off points and pain relationship

Background/aim: Thoracic spine insufficiency is a subject of interest in neck problems. The aim was to investigate thoracic spinal curvature and mobility in subjects with and without chronic neck pain (CNP), cut-off points, and the relationship with pain. Materials and methods: Fifty-six patients with CNP (CNP group) and 53 healthy volunteers (control group) were included. Neck pain intensity of the patients was assessed by visual analogue scale and sagittal thoracic curvature and mobility of all participants were assessed by Spinal Mouse (Idiag, Fehraltorf, Switzerland). Results: Thoracic curvature was higher (P < 0.001) and mobility lower in the CNP group in comparison to the control group (P = 0.013). There was a positive correlation between pain intensity and thoracic curvature (r = 0.391, P < 0.001), while there was a negative correlation between pain intensity and thoracic mobility (r = 0.260, P = 0.006). For detecting neck pain, it was observed that the cut-off points for thoracic curvature and mobility were 45.5° and 30.0°, respectively. Conclusions: An increase in thoracic curvature of more than 45° and a decrease in mobility more than 30° may be critical for CNP patients.

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1. Croft PR, Lewis M, Papageorgiou AC, Thomas E, Jayson MIV, Macfarlane GJ, Silman AJ. Risk factors for neck pain: a longitudinal study in the general population. Pain 2001; 93: 317-325.
2. Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J 2006; 15: 834-848.
3. Côté P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, Carragee EJ, Haldeman S, Nordin M, Hurwitz EL et al. The burden and determinants of neck pain in workers. Results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Spine (PhilaPa 1976) 2008; 33: S60-74.
4. Hogg-Johnson S, van der Velde G, Carroll LJ, Holm LW, Cassidy JD, Guzman J, Côté P, Haldeman S, Ammendolia C, Carragee E et al. The burden and determinants of neck pain in the general population: Results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Eur Spine J 2008; 17: S39-51.
5. Janda V. The significance of muscular faulty posture as pathogenetic factor of vertebral disorders. Arch Phys Ther (Leipz) 1968; 20: 113-116.
6. Lau KT, Cheung KY, Chan KB, Chan MH, Lo KY, Chiu TTW. Relationships between sagittal postures of thoracic and cervical spine, presence of neck pain, neck pain severity and disability. Man Ther 2010; 15: 457-462.
7. Silva AG, Punt TD, Sharples P, Vilas-Boas JP, Johnson MI. Head posture and neck pain of chronic nontraumatic origin: a comparison between patients and pain-free persons. Arch Phys Med Rehabil 2009; 90: 669-674.
8. Yip CHT, Chiu TTW, Poon ATK. The relationship between head posture and severity and disability of patients with neck pain. Man Ther 2008; 13: 148-154.
9. Balzini L, Vannucchi L, Benvenuti F, Benucci M, Monni M, Cappozzo A, Stanhope SJ. Clinical characteristics of flexed posture in elderly women. J Am Geriatr Soc 2003; 51: 1419-1426.
10. Quek J, Pua YH, Clark RA, Bryant AL. Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Man Ther 2013; 18: 65-71.
11. Norlander S, Gustavsson BA, Lindell J, Nordgren B. Reduced mobility in the cervico-thoracic motion segment: a risk factor for musculoskeletal neck-shoulder pain: a two-year prospective follow-up study. Scand J Rehabil Med 1997; 29: 167-174.
12. Norlander S, Nordgren B. Clinical symptoms related to musculoskeletal neck shoulder pain and mobility in the cervicothoracic spine. Scand J Rehabil Med 1998; 30: 243-251.
13. Wirth B, Amstalden M, Perk M, Boutellier U, Humphreys BK. Respiratory dysfunction in patients with chronic neckpain - influence of thoracic spine and chest mobility. Man Ther 2014; 19: 440-444.
14. Suvarnnato T, Puntumetakul R, Kaber D, Boucaut R, Boonphakob Y, Arayawichanon P, Chatchawan U. The effects of thoracic manipulation versus mobilization for chronic neck pain: a randomized controlled trial pilot study. J Phys Ther Sci 2013; 25: 865-871.
15. Salom-Moreno J, Ortega-Santiago R, Cleland JA, PalaciosCeña M, Truyols-Domínguez S, Fernández-de-las-Peñas C. Immediate changes in neck pain intensity and widespread pressure pain sensitivity in patients with bilateral chronic mechanical neck pain: a randomized controlled trial of thoracic thrust manipulation vs non-thrust mobilization. J Manip Physiol Ther 2014; 37: 312-319.
16. Celenay ST, Akbayrak T, Kaya DO. A comparison of the effects of stabilization exercises plus manual therapy to those of stabilization exercises alone in patients with nonspecific mechanical neck pain: a randomized clinical trial. J Orthop Sports Phys Ther 2016; 46: 44-55.
17. Celenay ST, Kaya DO, Akbayrak T. Cervical and scapulothoracic stabilization exercises with and without connective tissue massage for chronic mechanical neck pain: a prospective, randomised controlled trial. Man Ther 2016; 21: 144-150.
18. Nejati P, Lotfian S, Moezy A, Moezy A, Nejati M. The relationship of forward head posture and rounded shoulders with neck pain in Iranian office workers. Med J Islam Repub Iran 2014; 28: 26.
19. Tsunoda D, Iizuka Y, Iizuka H, Nishinome M, Kobayashi R, Ara T, Yamamoto A, Takagishi K. Associations between neck and shoulder pain (called katakori in Japanese) and sagittal spinal alignment parameters among the general population. J Orthop Sci 2013; 18: 216-219.
20. Clark P, Lavielle P, Martínez H. Learning from pain scales: patient perspective. J Rheumatol 2003; 30: 1584-1588.
21. Post RB, Leferink VJ. Spinal mobility: sagittal range of motion measured with the Spinal Mouse, a new non-invasive device. Arch Orthop Trauma Surg 2004; 124: 187-192.
22. Mannion AF, Knecht K, Balaban G, Dvorak J, Grob D. A new skin surface device for measuring the curvature, and global and segmental ranges of motion of the spine: reliability of measurements and comparison with data reviewed from the literature. Eur Spine J 2004; 13: 122-136.
23. Hinman MR. Comparison of thoracic kyphosis and postural stiffness in younger and older women. Spine J 2004; 4: 413-417.
24. Jull G, Sterling M, Falla D, Treleaven J, OLeary S. Whiplash, headache, and neck pain: research-based directions for physical therapies. 1st ed. Edinburgh, UK: Churchill Livingstone, Elsevier; 2008.
25. Keller S, Mannion A, Grob D. Reliability of a new measuring device (Spinal Mouse) in recording the sagittal profile of the back. Eur Spine J 2008; 9: 303.
26. Lundon KM, Li AM, Bibershtein S. Interrater and intrarater reliability in the measurement of kyphosis in postmenopausal women with osteoporosis. Spine (Phila Pa 1976) 1998; 23: 1978-1985.
27. Imagama S, Matsuyama Y, Hasegawa Y, Sakai Y, Ito Z, Ishiguro N, Hamajima N. Back muscle strength and spinal mobility are predictors of quality of life in middle-aged and elderly males. Eur Spine J 2011; 20: 954-961.
28. Mejia EA, HennrikusWL, Schwend RM, Emans J. A prospective evaluation of idiopathic left thoracic scoliosis with magnetic resonance imaging. J Pediatr Orthop 1996; 16: 354-358.