Chronic Neck Pain Patients Research Articles

The Effect of a Rehabilitation Exercise Program on Head Repositioning Accuracy and Reported Levels of Pain in Chronic Neck Pain Subjects

AbstractObjectives. Currently, there is limited research on the effectiveness of rehabilitative exercises for neck pain patients generally, and chronic neck pain patients in particular. Interestingly, recent evidence suggests that dysfunction of cervicocephalic kinesthesia, as measured by head repositioning accuracy (HRA), is present in many chronic patients, and that active eye-head-neck, co-ordination exercises, may be useful in terms of patients' rehabilitation.The purpose of this study was twofold: i. to determine if there was a difference in HRA in chronic neck pain subjects versus controls; ii. to assess the effect of a rehabilitative exercise program on chronic neck pain subjects' HRA and reported levels of pain.Method A prospective, intervention study on a convenience sample of chronic neck pain subjects (> 3 months duration) versus age and gender matched, asymptomatic control subjects was conducted. Exclusion criteria included any form of active treatment (> 1 per month) for musculoskeletal compl...

Knowledge of and Agreement with Chronic Pain Diagnosis: Relation to Affective Distress, Pain Beliefs and Coping, Pain Intensity, and Disability

Many authors report that a high percentage of patients with chronic pain have no or insufficient underlying physical pathology to explain their pain. Even when patients do have an identified diagnosis, many patients profess to have little understanding of the source of their pain or fear that they may suffer from more severe pathology. This may be particularly true for patients with chronic musculoskeletal pain given the lack of “objective” findings for soft tissue pain complaints. In the present study, we examined whether chronic neck and back pain patients were able to identify the physiologic source of their pain, and based on their responses patients were placed in one of three groups: (1) patients who did not know the cause of their pain; (2) patients who did know the cause and agreed with their clinical diagnosis; and (3) patients who identified a cause for their pain that was different from their clinical diagnosis. The sample was comprised primarily of individuals with musculoskeletal pain problems (70%) referred to an outpatient chronic pain rehabilitation program. Each patient completed a pretreatment test battery, and group differences were examined on responses to the McGill Pain Questionnaire, Survey of Pain Attitudes, Brief Symptom Inventory, Coping Strategies Questionnaire, and Pain Disability Index. Upon initial evaluation, 47.2%(n = 85) of patients indicated that they did not know what was causing their pain. Of patients who articulated a cause for their pain, 20%(n = 36) attributed it to factors that did not agree with their diagnosis. Only 32.8%(n = 59) of persons in the entire sample were able to accurately identify the cause of their pain. Patients who disagreed with their clinical diagnosis were more likely to be diagnosed with musculoskeletal pain and reported the highest levels of pain(F(2,169) = 3.41, p > .05) as well as the greatest levels of affective distress(F(2,169) = 3.54, p > .05). Patients who were unsure of or disagreed with their diagnosis tended to report a greater belief in pain being a signal of harm(F(2,169) = 11.5, p > .001) and described themselves as more disabled(F(2,169) = 8.43, p > .001). In addition, both the “unsure” and “disagree” groups tended to use maladaptive pain strategies more frequently, and persons unsure of their diagnosis had the lowest levels of perceived control over pain. A hierarchical regression analysis examining a cognitive/behavioral model of pain disability indicated that lack of knowledge of pain etiology, a belief that pain is a signal of harm, catastrophizing and affective distress all significantly predicted increased disability, while pain intensity did not. The data suggests that lack of knowledge about the origin of pain is associated with maladaptive cognitions in relation to pain (i.e., fear of harming oneself and catastrophizing) and increased emotional distress which in turn are related to heightened disability due to pain. These data argue that educating patients regarding their diagnosis and the origin of their pain, thereby dispelling dysfunctional pain beliefs, may be an important component of pain treatment, particularly among patients with chronic musculoskeletal pain.

The physiology of deranged behavior.

Abstract A dentist is privy to the secrets of medicine, but just outside the medical fraternity. Leaning on his father's prior thirty years clinical experience in dentistry, Steven Green has worked with the medical “wastebasket” of chronic head and neck pain patients for another thirty years. Sophisticated medicine and surgery often wreaked havoc to these fragile patients in a way similar to the proverbial bull in the china shop. Psychologists were generally supportive, but only occasionally curative. Now nutritional therapies often provide answers for patients previously crippled by their treatments. Idealizing one's daily diet and the therapeutic use of nutritional supplements are discussed with relation to preventing and healing various mental and physical health imbalances.

Management of chronic head and neck pain: effectiveness of altering factors perpetuating myofascial pain.

SYNOPSISThe response of 25 chronic myofascial head and neck pain patients to a systematic musculoskeletal rehabilitation program was examined. The program emphasized the acquisition of self‐management skills through a highly structured interdisciplinary format. Physical and cognitive behavioral therapies were aimed at reducing factors which perpetuate myofascial pain. Results immediately following treatment, and at three, six and twelvemonths post‐treatment when compared to pretreatment scores, showed highly reliable reductions in self‐reports of pain and medication intake.