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This study demonstrated that symptomatic individuals had increased muscle activity in the neck–shoulder region when texting on a smartphone. Contemporary ergonomic guidelines should include advice on how to interact with handheld electronic devices to achieve a relaxed posture and reduced muscle load in order to reduce the risk of musculoskeletal disorders.

This systematic review and meta-analysis examined the evidence for altered central pain processing in people with non-traumatic neck pain and the relationship between central pain processing, demographics and pain-related characteristics. Case-control studies reporting measures of altered central pain processing using quantitative sensory testing were reviewed. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) between people with non-traumatic neck pain and controls were calculated. Meta-analysis was performed using random-effects models when appropriate. Associations between SMDs with demographics and pain-related characteristics were explored on a study level using meta-regression. Twenty-six studies were eligible with 25 included for meta-analysis. Meta-analysis demonstrated mechanical hyperalgesia at remote non-painful sites in the full sample [sample size (n)=1305, SMD=-0.68] and in the subgroup with moderate/severe disability [n=165, SMD=-0.86] (moderate-quality evidence). Meta-regression indicated that remote mechanical hyperalgesia was negatively associated with age (R 2 =25.4%, P=0.031). Very-low-to low-quality evidence of remote cold and heat hyperalgesia and dysfunctional conditioned pain modulation were identified. This review suggests that altered central pain processing is present in people with non-traumatic neck pain and may be associated with disability levels and age.

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To better understand the mechanisms underpinning work-related neck pain, this cross-sectional and single-blinded study compared somatosensory profiles among sonographers with varied neck disability levels. Based on K-mean cluster analysis of scores on the neck disability index (NDI), participants were classified into no (NDI ≤ 8%, n = 31, reference group), mild (NDI = 10%-20%, n = 43), or moderate/severe (NDI ≥ 22%, n = 18) disability groups. Data were collected on bodily pain distribution and severity and psychological measures including depression, anxiety, pain-catastrophizing, and fear-avoidance beliefs using validated scales. Participants attended 1 session of quantitative sensory testing performed according to a standardized protocol, including local and remote thermal and mechanical pain thresholds, temporal summation of pain (TSP), conditioned pain modulation, and an exercise-induced analgesia paradigm. Compared with participants with no and mild disability, those with moderate/severe disability showed more widespread pain, cold and mechanical hyperalgesia at a remote nonpainful site, and significantly higher TSP. Participants with mild disability demonstrated significantly higher TSP than those with no disability. These group differences were attenuated after adjusting for depression or anxiety, indicating these psychological factors may mediate the somatosensory changes associated with neck disability. Group differences were not found for conditioned pain modulation or exercise-induced analgesia. These findings suggest that heightened pain facilitation, rather than impaired pain inhibition may underpin nociplastic pain in participants with moderate/severe disability, and it may be associated with depression and anxiety. Clinicians should be aware that individuals with work-related neck pain presenting with moderate/severe disability display distinct somatosensory features and tailor management strategies accordingly.

Stretching is commonly recommended before and after exercise; however, this study showed no significant impact of DS or SS in treating DOMS.

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