Efficacy of Cervical Stabilization Exercises on Hand Grip Strength in Chronic Myofascial Neck Pain

Efficacy of Cervical Stabilization Exercises on Hand Grip Strength, Pinch Strength, Pain Pressure Threshold in Patients With Chronic Myofascial Neck Pain

The purpose of this study is to examine effect of cervical stabilization exercises on hand grip strength, key pinch strength, pain intensity, pain pressure threshold and hand function in chronic myofascial neck pain patients.

Myofascial pain of the trapezius is considered one of the main causes of neck pain and characterized by deep, intense pain of the skeletal muscles and their fascia and by the presence of one or more MTrPs, Although MTrPs can be formed in any muscle or muscle group, previous studies concluded that the upper trapezius(UT) muscle is the most commonly affected muscle.

Considering the role of synergistic function of the UT muscle in scapula-humeral rhythm during shoulder movement, it is not surprising that MTrPs in UT muscle can result in shoulder dysfunction and disability. Muscle activity of proximal parts is necessary for activation of distal parts. In fact, the stable activity of distal parts needs controlling the proximal parts. Thus, the stability of shoulder girdle is required for activity of distal parts such as fingers, wrists and elbows. In addition, trigger points in the UT can affect grip strength, which depends on shoulder joint and scapular stability. Thus, UT muscle dysfunction can reduce grip strength.

However, little research has been carried out to determine the therapeutic effects of cervical stabilization exercises on chronic neck pain, and up till now, there is a gap in literature to explore efficacy of cervical stabilization exercises on chronic neck pain and hand grip strength. Therefore, this study aims to investigate whether cervical stabilization exercises has an effect on hand grip strength in chronic myofascial neck pain.

Inclusion Criteria:

1. Chronic neck pain for more than 3 months.
2. Active MTrPs in the UT muscle with a tender nodule.
3. Constant neck pain, a jump sign during palpation of UT muscle.
4. Referred pain.
5. Symptoms of ipsilateral hand muscles weakness.

Exclusion Criteria:

1. Signs of severe pathology such as malignancy of the cervical area.
2. Fractures of the cervical spine.
3. Cervical radiculopathy or myelopathy.
4. Diabetes.
5. Trauma, congenital anomalies and surgery around neck, shoulder and hand.
6. Fibromyalgia or vascular syndromes such as vertebra-basilar insufficiency.
7. Pregnancy.