Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review
Top Cited Papers
Open Access
- 12 January 2021
- journal article
- review article
- Published by Springer Science and Business Media LLC in Pain and Therapy
- Vol. 10 (1), 143-164
- https://doi.org/10.1007/s40122-020-00230-z
Abstract
Neck pain is very common, but most of the causes are unknown, making diagnosis and treatment extremely challenging. Current studies have found that one of the main problems in patients with neck pain is the impairment of cervical proprioception, which subsequently leads to cervical sensorimotor control disturbances. Cervical spine has a very delicate proprioceptive system that plays a crucial role in controlling posture and balance. Cervical proprioceptive impairment in neck pain occurs through a variety of mechanisms. Experimental neck muscle pain induced by injection of hypertonic saline results in inhibition of the activation of painful muscle; chronic neck pain causes structural and functional impairment of cervical muscles; excessive activation of mechanoreceptors in degenerative cervical discs and facet joints produces a large number of erroneous sensory signals. Clinical examinations to assess the link between structural pathology and neck pain have been unsuccessful, opening the way for the development of function-based tests. To date, eight neck sensorimotor control tests have been reported to evaluate patients with chronic neck pain. Although some tests may involve different subsystems (such as oculomotor system and vestibular system), all tests measure sensorimotor control in the neck, and the most commonly used is cervical joint position error (JPE) test. Current studies support the effectiveness of exercises targeting different aspects of sensorimotor function, in particular retraining aimed at improving cervical proprioception and muscle coordination. Based on the available evidence, it is recommended that patients with neck pain should be assessed and managed for cervical proprioceptive impairment and sensorimotor control disturbances.Keywords
This publication has 129 references indexed in Scilit:
- Is There Altered Activity of the Extensor Muscles in Chronic Mechanical Neck Pain? A Functional Magnetic Resonance Imaging StudyArchives of Physical Medicine and Rehabilitation, 2011
- The characteristics of the mechanoreceptors of the hip with arthrosisJournal of Orthopaedic Surgery and Research, 2011
- “The Fly”: A New Clinical Assessment and Treatment Method for Deficits of Movement Control in the Cervical SpineSpine, 2010
- Position accuracy and electromyographic responses during head reposition in young adults with chronic neck painJournal of Electromyography and Kinesiology, 2010
- Cervicocephalic kinesthetic sensibility and postural balance in patients with nontraumatic chronic neck pain – a pilot studyChiropractic & Manual Therapies, 2009
- A novel method for neck coordination exercise – a pilot study on persons with chronic non-specific neck painJournal of NeuroEngineering and Rehabilitation, 2008
- Altered motor control patterns in whiplash and chronic neck painBMC Musculoskeletal Disorders, 2008
- The influence of pain on masseter spindle afferent dischargeArchives of Oral Biology, 2007
- The prevalence of neck pain in the world population: a systematic critical review of the literatureEuropean Spine Journal, 2005
- The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activityCanadian Journal of Physiology and Pharmacology, 1991