Abstract
BackgroundMany 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.MethodsClinical 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'.ResultsIn 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.ConclusionsA 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 RegistrationISRCTN60264809
Highlights
The prevalence of severe tenderness ranged between 18-30% in the infraspinatus, neck extensors and levator scapulae, and ranged between 13-19% in the upper trapezius, occipital border, and supraspinatus
Our study shows a high prevalence of tenderness in several anatomical locations of the neck/shoulder complex among generally healthy adults with nonspecific neck/ shoulder pain
Trapezius myalgia - chronic tenderness and tightness of the upper trapezius muscle - is the most common clinical diagnosis in adults with self-reported neck/shoulder pain [8], our results show that severe tenderness more commonly occurs in the levator scapulae, neck extensors and infraspinatus
Summary
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. A high prevalence of upper extremity pain exists among adults working in sedentary occupations [1]. Kaergaard and coworkers found a strong correlation between reported neck/shoulder pain and clinically verified muscle tenderness [7]. Tenderness of the upper trapezius muscle often co-exists with neck/ shoulder pain [6,8,9]. In spite of the inordinate focus on the upper trapezius, other muscles of the neck/shoulder complex may be affected as well - and should not be overlooked when treating neck/shoulder pain
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