Effect of Chronic Neck Pain on Pulmonary Function

Chronic Neck pain is one of the most common musculoskeletal pain conditions experienced by many people during their lives. People with neck pain are generally managed with specific exercises and stretches to maintain mobility and function. There are indications that they may also have poor pulmonary function related to postural abnormalities, weakness and fatigue of cervico-thoracic musculature, impaired proprioception and psychological compromise.

 

A recent study by Dimitriadis et al (2015) examined the effect that chronic neck pain has on pulmonary function using spirometry. Spirometry is a common test that provides information regarding the presence of obstruction or restriction in people with suspected pulmonary dysfunction.

 

The study compared cervical spine range and strength and deep neck flexor control as well as spirometric function in symptomatic subjects compared to a normal control group.

 

It found that people with chronic neck pain demonstrated reduced respiratory strength and changes in their blood chemistry. They demonstrated decreased lung volumes and maximal voluntary ventilation (MVV). MVV is an index of maximal breathing capacity during dynamic exercise and is also associated with neuromuscular control. Its reduction in neck pain patients may imply interference in the nervous system- manifestations of respiratory dysfunction that are similar to respiratory patients with neuromuscular weakness.

 

The results of this study indicate that that respiratory dysfunction in patients with chronic neck pain is associated with cervical muscle dysfunction, pain intensity and kinesiophobia. Impaired function of common cervical muscles- sternocleidomastoid, scalene, and trapezius may have had a direct effect on lung function or be contributors to muscle imbalance through an effect on ribcage mechanics and on the biomechanical function of respiratory muscles.

 

In the long term the reduction in lung flow and volumes may render the spinal and rib articulations stiffer further contributing to the development of a restrictive pulmonary pattern.

 

The results of this study support the incorporation of respiratory assessment and rehabilitation along the lines of breathing exercises into the usual treatment of patients with chronic neck pain.

 

Workplace Physiotherapy routinely incorporates education on breathing and breathing correction exercises into existing exercise based programs for chronic neck pain.

 

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Ref: Dimitriadis Z, Nikolaos EK, Oldham A. Journal of Pulmonary function of Patients with Chronic Neck Pain: A Spirometry Study.Respiatory Care April 2014. Vol 59, No 4

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The comments above are the implicit advice of Workplace Physiotherapy. The views expressed are based on current evidence-based research and accepted best practice approaches. Unless otherwise stated, these comments are not the view of WorkCover NSW or any other professional body. No reproduction or forwarding of this advice is permitted without the consent of the author.

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