Rehabilitation Therapy Program, University of Colorado Hospital, Aurora, Colorado 80045, USA.
Phys Ther. 2012 Oct;92(10):1348-59. doi: 10.2522/ptj.20110489. Epub 2012 Jun 14.
Chronic neck pain is prevalent in the workplace. Research suggests that psychosocial stress may contribute to the development of neck pain by causing excessive or prolonged muscle activity in some individuals. The purpose of this case report is to describe the rationale, development, and implementation of stress management as an adjunct to standard physical therapist management of chronic neck pain in a female office worker who responded to psychosocial stress with elevated muscle activity prior to treatment.
A 44-year-old female office employee with an 8-year history of chronic neck pain participated in this case report. The patient was selected from a group of research participants who demonstrated elevated electromyographic (EMG) activity of the trapezius muscle in response to simulated occupational stressors. The multidisciplinary intervention consisted of 8 physical therapy sessions, supplemented by 8 stress management sessions that included EMG biofeedback and psychotherapy to facilitate muscle relaxation.
Neck disability decreased by 50%, trait anxiety decreased by 21%, and the duration of trapezius muscle rest in the workplace increased by 56% immediately after the 8-week intervention. These improvements were maintained 6 months after treatment, and the patient reported a complete absence of neck disability at the 2-year follow-up assessment.
A sustained reduction in neck disability was observed for a patient with chronic neck pain after participating in a multidisciplinary intervention that combined physical therapy and stress management approaches to facilitate muscle relaxation in the workplace. Future clinical trials are needed to assess whether stress management is a useful adjunct therapy for patients with chronic neck pain who show elevated muscle activity in response to psychosocial stress.
慢性颈痛在工作场所中很常见。研究表明，心理社会压力可能通过在某些个体中引起过度或延长的肌肉活动而导致颈痛的发展。本病例报告的目的是描述在一位女性办公室工作人员中，将应激管理作为慢性颈痛标准物理治疗的辅助手段的原理、发展和实施情况，该患者在治疗前对心理社会压力的反应表现出肌肉活动升高。
一位 44 岁的女性办公室职员，患有 8 年慢性颈痛病史，参与了本病例报告。该患者是从一群表现出斜方肌肌电图（EMG）活动升高的研究参与者中选择出来的，这些参与者对模拟职业应激源有反应。多学科干预包括 8 次物理治疗课程，以及 8 次应激管理课程，包括 EMG 生物反馈和心理治疗，以促进肌肉放松。
颈痛残疾程度降低了 50%，特质焦虑降低了 21%，工作中斜方肌休息时间增加了 56%，这些改善在治疗后 6 个月仍然存在，并且患者在 2 年随访评估时报告完全没有颈痛残疾。
一位慢性颈痛患者在接受结合物理治疗和应激管理方法的多学科干预后，颈痛残疾程度持续降低，促进了工作中肌肉的放松。需要进一步的临床试验来评估应激管理是否是对表现出对心理社会压力反应性肌肉活动升高的慢性颈痛患者有用的辅助治疗方法。
