Differences in pain characteristics, associated symptoms, and physical impairments according to resting scapular position in people with chronic non-specific neck pain: a cross-sectional study.

BACKGROUND

Altered resting scapular position is commonly observed in people with chronic non-specific neck pain. However, clinical characteristics associated with different patterns of resting scapular dysfunction remain unclear.

OBJECTIVE

To compare neck pain characteristics, associated symptoms, and physical impairments among people with chronic non-specific neck pain with resting scapular downward rotation (SDR), those with resting scapular protraction, those without resting scapular dysfunction, and asymptomatic controls without resting scapular dysfunction.

METHODS

A total of 144 participants were recruited (36 in each group). Outcome measures included neck pain characteristics (intensity, disability, duration, and area), associated symptoms (headache and dizziness), and physical impairments (cervical range of motion (ROM), flexion rotation test(FRT), cervical and shoulder joint position errors (JPEs), and pressure pain thresholds (PPTs) at C5-C6 zygapophyseal joints, upper trapezius, levator scapulae, and tibialis anterior).

RESULTS

All neck pain groups showed greater pain, symptoms, and physical impairments than controls (all p < .01, ηP2 = 0.28-0.74). The neck pain group with resting SDR demonstrated the greatest impairments, including higher pain intensity, upper and whole neck pain, headache and dizziness, reduced cervical ROM and FRT range, increased cervical and shoulder JPEs, and lower PPTs at local and remote sites (all p < .01, ηp2 = 0.23-0.72). Conversely, the neck pain group with resting scapular protraction exhibited clinical features similar to those without resting scapular dysfunction, including lower neck and upper trapezius pain, decreased cervical ROM, increased cervical and shoulder JPEs, and reduced PPTs at local sites (all p < .01, ηP2 = 0.28-0.74).

CONCLUSION

Patterns of resting scapular dysfunction may represent distinct clinical phenotypes in people with chronic non-specific neck pain. Resting SDR was associated with more severe and widespread clinical deficits, highlighting the importance of considering both biomechanical and pain mechanisms in clinical evaluation and management of this population.