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30-03-2014 | Pain medicine | Article

Anatomic parameters predict chronic neck pain


Free abstract

medwireNews: Researchers have found that a shallow rib cage in women and forward inclination of the thoracic inlet in men are associated with the development of chronic neck pain.

They report that, in multivariate analysis, each mm increase in the anteroposterior dimension of the uppermost thoracic cage, between the top of the manubrium and the tip of the T1 spinous process, was associated with an 18% decrease in the risk of chronic neck pain in women and a 19% decrease in men.

This section forms a fixed base for head and neck movement, and the smaller the base, the more likely that the head will extend beyond it, explain lead researcher Youn-Kwan Park (Korea University Guro Hospital, Seoul, Republic of South Korea) and team.

“This in turn may increase neck extensor activity causing neck muscle fatigue,” they say.

In men only, each degree increase in the angle of thoracic inlet inclination also increased the risk of chronic neck pain by 25%.

“The steeper the slope and the higher T1 [vertebra], the more prone it is to move over the weight-bearing center when leaning forward”, the researchers comment in The Spine Journal. “In turn, this may increase neck extensor activity, resulting in neck muscle fatigue.”

The findings are based on the mid-sagittal magnetic resonance imaging scans of the cervicothoracic spines of 48 people (23 men and 25 women) suffering with axial neck pain for more than 6 months and 48 people (23 men and 25 women) free of pain, which were taken when they were lying in the supine position. The participants were all young adults aged 20 to 40 years.

The researchers believe that thoracic cage size and thoracic inlet inclination may make important predictors for chronic neck pain.

They add that the parameters in their study were related to skeletal attributes rather than muscular imbalance and, due to being in a young adult population, were likely to be developmental rather than acquired, adaptive or degenerative.

The team therefore suggests that individuals with these potential risk factors “might benefit from preventive measures, such as postural adaptation or ergonomic support, to lessen the chance of the development of weak points in daily life or strengthen the muscles holding the structures so as to eliminate fatigue.”

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2014

By Lucy Piper, Senior medwireNews Reporter