Movement dysfunction and disability in patients with chronic non-specific neck pain

Abstract

Background: Neck pain is a highly prevalent global health issue, with approximately two-thirds of the population experiencing it at least once in their lifetime. Prevalence is highest among middle-aged adults, ranging from 22% to 70%. Up to 54% of individuals report neck pain within the last six months, of which 37% develop chronic symptoms. According to the Global Burden of Disease Study, 203 million people suffered from neck pain in 2020, a figure projected to rise to 269 million by 2050. Chronic neck pain often involves neuromuscular changes, including reduced range of motion (ROM), impaired motor control, decreased movement velocity, and diminished joint position sense. These dysfunctions directly impact activities of daily living (ADL), leading to significant disability. Aim: To study the loss of mobility resulting from physical therapy for chronic non-specific neck pain. Materials and Methods: This study included 115 participants aged 30–59 with chronic non-specific neck pain. Informed consent was obtained from all participants. Following a clinical examination based on inclusion and exclusion criteria, movement control was assessed using 13 clinical tests (flexion, extension, and rotation) as described by Hannu Luomajoki et al. (2008). Disability was evaluated using the Neck Disability Index (NDI). Pain intensity at rest and during movement was measured using the Visual Analog Scale (VAS), and the cervical range of motion was determined using a goniometer. Results: The mean age of the participants was 37.38 \pm 12.00 years, with 76.5% (n=88) being female and 23.5% (n=27) male; the mean BMI was 24.59 \pm 3.55. Notably, 86.1% of participants were classified into the complex movement dysfunction group. A moderate positive correlation was observed between pain during movement and disability (r=0.331, p<0.001). However, movement control impairment did not show a statistically significant correlation with disability or pain levels (p>0.05). Regression analysis confirmed that pain is the primary factor influencing disability (p<0.001). Conclusion: In patients with non-specific neck pain, an increase in pain intensity is directly associated with higher levels of disability. Movement control impairment appears to be relatively independent of pain intensity, suggesting that clinical interventions should focus not only on pain reduction but also on specialized kinesiotherapy to improve movement quality.