Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain

Lars L Andersen, Klaus Hansen, Ole S Mortensen, Mette K Zebis, Lars L Andersen, Klaus Hansen, Ole S Mortensen, Mette K Zebis

Abstract

Background: Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain.

Methods: Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years) with nonspecific neck/shoulder pain for a duration of at least 30 days during the previous year and a pain intensity of at least 2 on a modified VAS-scale of 0-10 participated. Exclusion criteria were traumatic injuries or other serious chronic disease. Using a standardized finger pressure of 2 kg, palpable tenderness were performed of eight anatomical neck/shoulder locations in the left and right side on a scale of 'no tenderness', 'some tenderness' and 'severe tenderness'.

Results: In women, the levator scapulae, neck extensors and infraspinatus showed the highest prevalence of severe tenderness (18-30%). In comparison, the prevalence of severe tenderness in the upper trapezius, occipital border and supraspinatus was 13-19%. Severe tenderness of the medial deltoid was least prevalent (0-1%). In men, the prevalence of severe tenderness in the levator scapulae was 13-21%, and ranged between 0-8% in the remainder of the examined anatomical locations.

Conclusions: A high prevalence of tenderness exists in several anatomical locations of the neck/shoulder complex among adults with nonspecific neck/shoulder pain. Future research should focus on several neck/shoulder muscles, including the levator scapulae, neck extensors and infraspinatus, and not only the upper trapezius.

Trial registration: ISRCTN60264809.

Figures

Figure 1
Figure 1
Flow of participants.
Figure 2
Figure 2
Palpation of the eight examined neck/shoulder locations (only illustrated for the right side).

References

    1. Janwantanakul P, Pensri P, Jiamjarasrangsri V, Sinsongsook T. Prevalence of self-reported musculoskeletal symptoms among office workers. Occup Med (Lond) 2008;12:436–438. doi: 10.1093/occmed/kqn072.
    1. Andersen LL, Mortensen OS, Hansen JV, Burr H. A prospective cohort study on severe pain as a risk factor for long-term sickness absence in blue- and white-collar workers. Occup Environ Med. 2010.
    1. Blangsted AK, Sogaard K, Hansen EA, Hannerz H, Sjogaard G. One-year randomized controlled trial with different physical-activity programs to reduce musculoskeletal symptoms in the neck and shoulders among office workers. Scand J Work Environ Health. 2008;12:55–65.
    1. Buckle P. Ergonomics and musculoskeletal disorders: overview. Occup Med (Lond) 2005;12:164–167. doi: 10.1093/occmed/kqi081.
    1. Blangsted AK, Hansen K, Jensen C. Muscle activity during computer-based office work in relation to self-reported job demands and gender. Eur J Appl Physiol. 2003;12:352–358. doi: 10.1007/s00421-003-0805-7.
    1. Larsson B, Sogaard K, Rosendal L. Work related neck-shoulder pain: a review on magnitude, risk factors, biochemical characteristics, clinical picture and preventive interventions. Best Pract Res Clin Rheumatol. 2007;12:447–463. doi: 10.1016/j.berh.2007.02.015.
    1. Kaergaard A, Andersen JH, Rasmussen K, Mikkelsen S. Identification of neck-shoulder disorders in a 1 year follow-up study. Validation Of a questionnaire-based method. Pain. 2000;12:305–310. doi: 10.1016/S0304-3959(00)00261-X.
    1. Juul-Kristensen B, Kadefors R, Hansen K, Bystrom P, Sandsjo L, Sjogaard G. Clinical signs and physical function in neck and upper extremities among elderly female computer users: the NEW study. Eur J Appl Physiol. 2006;12:136–145. doi: 10.1007/s00421-004-1220-4.
    1. Andersen LL, Kjaer M, Sogaard K, Hansen L, Kryger AI, Sjogaard G. Effect of two contrasting types of physical exercise on chronic neck muscle pain. Arthritis Rheum. 2008;12:84–91. doi: 10.1002/art.23256.
    1. Andersen LL, Holtermann A, Jorgensen MB, Sjogaard G. Rapid muscle activation and force capacity in conditions of chronic musculoskeletal pain. Clin Biomech (Bristol, Avon) 2008;12:1237–1242. doi: 10.1016/j.clinbiomech.2008.08.002.
    1. Andersen LL, Nielsen PK, Sogaard K, Andersen CH, Skotte J, Sjogaard G. Torque-EMG-velocity relationship in female workers with chronic neck muscle pain. J Biomech. 2008;12:2029–2035. doi: 10.1016/j.jbiomech.2008.03.016.
    1. Andersen LL, Suetta C, Andersen JL, Kjær M, Sjøgaard G. Increased proportion of megafibers in chronically painful muscles. Pain. 2008;12:588–593. doi: 10.1016/j.pain.2008.06.013.
    1. Mackey AL, Andersen LL, Frandsen U, Suetta C, Sjogaard G. Distribution of myogenic progenitor cells and myonuclei is altered in women with vs. those without chronically painful trapezius muscle. J Appl Physiol. 2010.
    1. Rosendal L, Larsson B, Kristiansen J, Peolsson M, Sogaard K, Kjaer M, Sorensen J, Gerdle B. Increase in muscle nociceptive substances and anaerobic metabolism in patients with trapezius myalgia: microdialysis in rest and during exercise. Pain. 2004;12:324–334. doi: 10.1016/j.pain.2004.09.017.
    1. Ohlsson K, Attewell RG, Johnsson B, Ahlm A, Skerfving S. An assessment of neck and upper extremity disorders by questionnaire and clinical examination. Ergonomics. 1994;12:891–897. doi: 10.1080/00140139408963698.
    1. Andersen LL, Saervoll CA, Mortensen OS, Poulsen OM, Hannerz H, Zebis MK. Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial. Pain. 2010.
    1. Pincus T, Bergman M, Sokka T, Roth J, Swearingen C, Yazici Y. Visual analog scales in formats other than a 10 centimeter horizontal line to assess pain and other clinical data. J Rheumatol. 2008;12:1550–1558.
    1. Andersen LL, Kjaer M, Sogaard K, Hansen L, Kryger AI, Sjogaard G. Effect of two contrasting types of physical exercise on chronic neck muscle pain. Arthritis Rheum. 2008;12:84–91. doi: 10.1002/art.23256.
    1. Kuorinka I, Jonsson B, Kilbom Å, Vinterberg H, Biering-Sørensen F, Andersson G, Jørgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergo. 1987;12:233–237. doi: 10.1016/0003-6870(87)90010-X.
    1. Kelly SM, Brittle N, Allen GM. The value of physical tests for subacromial impingement syndrome: a study of diagnostic accuracy. Clin Rehabil. 2010;12:149–158. doi: 10.1177/0269215509346103.
    1. Tong HC, Haig AJ, Yamakawa K. The Spurling test and cervical radiculopathy. Spine (Phila Pa 1976) 2002;12:156–159. doi: 10.1097/00007632-200201150-00007.
    1. Andersen LL, Saervoll CA, Mortensen OS, Poulsen OM, Hannerz H, Zebis MK. Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial. Pain. 2011;12:440–446. doi: 10.1016/j.pain.2010.11.016.
    1. Bojsen-Møller F. Bevægeapparatets anatomi. København: Munksgaard Danmark; 2003.
    1. Veeger HE, van der Helm FC. Shoulder function: the perfect compromise between mobility and stability. J Biomech. 2007;12:2119–2129. doi: 10.1016/j.jbiomech.2006.10.016.
    1. Birch L, Juul-Kristensen B, Jensen C, Finsen L, Christensen H. Acute response to precision, time pressure and mental demand during simulated computer work. Scand J Work Environ Health. 2000;12:299–305.
    1. Henriksson KG. Hypersensitivity in muscle pain syndromes. Curr Pain Headache Rep. 2003;12:426–432. doi: 10.1007/s11916-003-0058-5.
    1. Chesterton LS, Barlas P, Foster NE, Baxter GD, Wright CC. Gender differences in pressure pain threshold in healthy humans. Pain. 2003;12:259–266. doi: 10.1016/S0304-3959(02)00330-5.
    1. Binderup AT, Arendt-Nielsen L, Madeleine P. Pressure pain sensitivity maps of the neck-shoulder and the low back regions in men and women. BMC Musculoskelet Disord. 2010;12:234. doi: 10.1186/1471-2474-11-234.
    1. Ge HY, Madeleine P, Cairns BE, Arendt-Nielsen L. Hypoalgesia in the referred pain areas after bilateral injections of hypertonic saline into the trapezius muscles of men and women: a potential experimental model of gender-specific differences. Clin J Pain. 2006;12:37–44. doi: 10.1097/01.ajp.0000149799.01123.38.
    1. Fernandez-de-las-Penas C, Simons D, Cuadrado ML, Pareja J. The role of myofascial trigger points in musculoskeletal pain syndromes of the head and neck. Curr Pain Headache Rep. 2007;12:365–372. doi: 10.1007/s11916-007-0219-z.

Source: PubMed

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