Does the region of pain influence the presence of sensorimotor disturbances in neck pain disorders?

Impairments in sensorimotor control have been demonstrated in neck pain disorders. However, there are more anatomical and neurophysiological connections between the sensorimotor control system and the upper cervical region and thus potential for greater disturbances in those with upper region pain. This study investigated whether sensorimotor impairment was greater in those suffering pain from the upper rather than lower cervical spine region, taking the onset of pain into account. Sixty-four subjects with persistent neck pain were divided into 4 groups -upper and lower region non-traumatic and upper and lower region traumatic. Cervical Joint Position Error (JPE), smooth pursuit neck torsion (SPNT) and standing balance tests were compared between groups. The lower non-traumatic group demonstrated significantly less (p < 0.03) deficit in SPNT compared to all other groups as well as less total energy of sway on the eyes open balance tests (p < 0.05) compared to both traumatic neck pain groups. The upper traumatic group demonstrated significantly greater JPE following rotation to the right (p < 0.04) when compared to both lower groups. Less sensorimotor dysfunction appears to occur in those with lower compared to upper cervical region pain, although this depends on whether trauma is involved in the onset of pain.