Recurrent neck pain patients exhibit altered joint motion pattern during cervical flexion and extension movements

Abstract Background Impaired sensorimotor ability has been demonstrated in recurrent neck pain patients. It is however not clear if cervical joint motion and pressure pain sensitivity in recurrent neck pain patients are different from asymptomatic controls. Methods Cervical flexion and extension motions were examined by video-fluoroscopy and pressure pain thresholds were assessed bilaterally over C2/C3, C5/C6 facet joints and right tibialis anterior in eighteen recurrent neck pain patients and eighteen healthy subjects. Individual joint motion was analyzed by dividing fluoroscopic videos into 10 epochs. The motion opposite to the primary direction (anti-directional motion) and motion along with the primary direction (pro-directional motion) of each joint were extracted across epochs. Total joint motion was the sum of anti-directional and pro-directional motions. Joint motion variability was represented by the variance of joint motions across epochs. Findings Compared to controls, recurrent neck pain patients showed: 1) decreased anti-directional motion at C2/C3 and C3/C4 (P  Interpretation Recurrent neck pain patients showed a redistribution of anti-directional motion between the middle cervical spine and the lower cervical spine during cervical extension and increased overall anti-directional motion during cervical flexion compared with healthy controls. The anti-directional motion was more sensitive to neck pain compared to other cervical joint motion parameters in the present study.