Prognostic Factor Analysis for Management of Chronic Neck Pain : Can We Predict the Severity of Neck Pain with Lateral Cervical Curvature?

Abstract

ObjectiveAlthough little is known about its origins, neck pain may be related to several associated anatomical pathologies. We aimed to characterize the incidence and features of chronic neck pain and analyze the relationship between neck pain severity and its affecting factors.MethodsBetween March 2012 and July 2013, we studied 216 patients with chronic neck pain. Initially, combined tramadol (37.5 mg) plus acetaminophen (325 mg) was administered orally twice daily (b.i.d.) to all patients over a 2-week period. After two weeks, patients were evaluated for neck pain during an outpatient clinic visit. If the numeric rating scale of the patient had not decreased to 5 or lower, a cervical medial branch block (MBB) was recommended after double-dosed previous medication trial. We classified all patients into two groups (mild vs. severe neck pain group), based on medication efficacy. Logistic regression tests were used to evaluate the factors associated with neck pain severity.ResultsA total of 198 patients were included in the analyses, due to follow-up loss in 18 patients. While medication was successful in reducing pain in 68.2% patients with chronic neck pain, the remaining patients required cervical MBB. Lateral cervical curvature, such as a straight or sigmoid type curve, was found to be significantly associated with the severity of neck pain.ConclusionWe managed chronic neck pain with a simple pharmacological management protocol followed by MBB. We should keep in mind that it may be difficult to manage the patient with straight or sigmoid lateral curvature only with oral medication.

Restoring cervical lordosis by cervical extension traction methods in the treatment of cervical spine disorders: a systematic review of controlled trials

“…Cervical spine alignment has been shown to be significantly related to patient outcomes; this has been particularly substantiated within the surgical literature 6,9,10) , but also in some manual therapy literature 11,12) . Cervical kyphosis, for example, is considered a spinal deformity and is associated with pain and disability [13][14][15] . Altered cervical spine alignment is associated with various specific craniocervical symptoms including headache [16][17][18][19] , migraine 19,20) , as well as radiculopathy and myelopathy 21,22) .…”

Variation characteristics of cervical sagittal parameters between patients with nonspecific neck pain and patients with radiculotic and cervical spondylotic myelopathy: A cross-sectional study

“…When the C2-C7 Cobb angle decreases, the center of gravity of the head (CGH) and C2 vertebrae moves forward, which will lead to the same increase of C2-C7 SVA to maintain balance and offset the adverse effects caused by CGH moving forward [3]. The research results in this paper also show that C2-C7 Cobb angle has a positive correlation with T1 and C7 slopes, which indicates that when this angle is reduced, T1 and C7 slopes will also be reduced to compensate for this and reduce the related imbalance effects [22,[25][26][27]. When the physiological curvature of the cervical spine is reduced, many parameters of the cervical spine will change, and there is correlation between these changes.…”

The Association Between Cervical Spine Alignment and Neck Axial Pain in Early Twenties Soldiers

“…The kyphotic changes of the cervical disc spaces were degenerative, which caused axial overload in the anterior cervical column 1,6) . The other study revealed that this pathologic change in the cervical spinal disc was an important pathogenic factor of cervicalgia 30) . We hypothesized that the kyphotic change in each segment was affected by cervical axial pain.…”

“…Cervicalgia in more than 50% of people lasted for one year or more after the initial onset [2][3][4][5]7,22,28) . Though the cause of neck pain is not well established yet, many lesions such as degenerative changes of the disc and facet, ligament, fascia, muscle, nerve root, and dura could be the possibilities 30) .…”