Physical and Psychological Features During Remission From Non-Specific Neck Pain.

BACKGROUND: There is limited evidence on the physical and psychological features present during remission from non-specific neck pain, yet this may be relevant for the high incidence of neck pain recurrence. METHODS: A cross-sectional study design was conducted with 60 participants (20 per group: healthy controls, people in remission from recurrent neck pain, current chronic neck pain) who were assessed for pressure pain thresholds, conditioned pain modulation, cervical kinematics, proprioception, neck muscle strength, neck muscle activity via electromyography, force steadiness, endurance, and psychological features. RESULTS: People in remission and those with current neck pain demonstrated reduced maximal velocity (p ≤ 0.05) and smoothness of movement (p ≤ 0.05) during neck extension, rotation, and side flexion compared to controls. Shoulder shrug strength (p ≤ 0.001) was also reduced in both pain groups. Maximal angular velocity and smoothness of neck flexion movement, as well as peak neck extension strength, were reduced only in those in remission compared to controls (p ≤ 0.01). Those with current neck pain distinctively showed reduced neck flexion strength, reduced force steadiness during submaximal neck flexion and extension contractions, heightened antagonist coactivity, and less endurance for the neck flexors and extensors (p ≤ 0.05). CONCLUSION: Individuals in remission from neck pain exhibit some alterations in cervical kinematics, motor output and neuromuscular control resembling similar impairments to those with current chronic neck pain despite being pain-free. Such features may be relevant for pain recurrence, and this should be explored in future longitudinal studies. SIGNIFICANCE STATEMENT: This study identifies changes in physical function of the neck which are present in people with active chronic non-specific neck pain that are also evident during remission from pain. Such findings provide an understanding of the previously underexplored clinical presentation during neck pain remission. If determined to be relevant, specific interventions to target these changes could be provided to optimise functional capacity with the aim of minimising or preventing the recurrence of pain.