Factors Associated with Neck and Shoulder Pain in Volunteers

Abstract

Introduction: The aims of the present study were 1) to examine the association between neck and shoulder pain (NSP) and lifestyle in the general population and 2) to examine if sagittal spino-pelvic malalignment is more prevalent in NSP.

Methods: A total of 107 volunteers (mean age, 64.5 years) were recruited in this study from listings of resident registrations in Kihoku region, Wakayama, Japan. Feeling pain or stiffness in the neck or shoulders was defined as an NSP. The items studied were: 1) the existence or lack of NSP and their severity (using VAS scale), 2) Short Form-36 (SF-36), 3) Self-Rating Questionnaire for Depression (SRQ-D), 4) Pain Catastrophizing Scale (PCS), 5) a detailed history consisting of 5 domains as being relevant to the psychosocial situation of patients with chronic pain, 6) A VAS of pain and numbness to the arm, and from thoracic region to legs. The radiographic parameters evaluated were also measured. Participants with a VAS score of 40 mm or higher and less were divided into 2 groups. Association of SF-36, SRQ-D, and PCS with NSP were assessed using multiple regression analysis.

Results: In terms of QoL, psychological assessment and a detailed history, bodily pain in SF-36, SRQ-D, and family stress were significantly associated with NSP. A VAS of pain and numbness to the arm, and from thoracic region to legs, was significantly associated with NSP. There were no statistical correlations between the VAS and radiographic parameters of the cervical spine. Among the whole spine sagittal measurements, multiple logistic regression analysis showed that sacral slope (SS) and sagittal vertical axis (SVA) were significantly associated with NSP.

Conclusion: In this study, we showed the factors associated with NSP. Large SS and reduced SVA were significantly associated with NSP, while cervical spine measurements were not.

Keywords: cervical sagittal vertical axis; cervical spine; lifestyle; neck and shoulder pain; sacral slope; sagittal spino-pelvic alignment.

Figure 1.

(A), (B), and (C) depict the measurement of the various cervical spine parameters discussed in this manuscript. (A) C2-7 tilt: the angle from centroid of C2 to lower end of C7, to perpendicular line of C7 lower end. (B) C1-7 distance: the distance from the posterior superior corner of C7 to the plumb line from the C1anterior arch. (C) Atlantoaxial angle (AAA): measured by the angle subtended between a line connecting the inferior edges of the posterior and anterior arches of C1 and the inferior endplate of C2. C2-7 distance: the distance from the posterior, superior corner of C7 to the plumb line from the centroid of C2. Cervical lordosis (CL): the angle subtended by lines drawn along the posterior vertebral bodies of C2 and C7. T1 tilt: the angle from the horizontal to the upper end, plate of the T1 vertebra.

Figure 2.

(A) and (B) depict the measurement of the various spino-pelvic parameters discussed in the manuscript. (A) Thoracic kyphosis (TK): the angle subtended by lines drawn along the posterior vertebral bodies of T1 and T12. Lumbar lordosis (LL): the angle from the upper endplate of L1 to the upper end plate of S1. Sacral slope (SS): the angle between the superior endplate of S1 and a horizontal axis. (B) C7 sagittal vertical axis (SVA): defined as the horizontal distance between the C7 plumb line and the posterior superior corner of the superior margin of S1. Pelvic tilt (PT): the angle between the line connecting the midpoint of the sacral plate to the axis of the femoral heads and the vertical axis. Pelvic incidence (PI): the angle between the perpendicular to the sacral plate at its midpoint and the line connecting the point to the middle axis of the femoral heads.

Figure 3.

The defined area of neck shoulder pain.

Figure 4.

The association between NSP and cervical ROM.