Requejo-Salinas Néstor, Fernández-Matías Rubén, Gordo Herrera Javier, Conesa López Pablo, La Touche Roy, Lluch-Girbés Enrique
Department of Physical Therapy, Superior Center for University Studies La Salle, Autonomous University of Madrid, Madrid - Spain.
International Doctoral School, Rey Juan Carlos University, Alcorcón - Spain.
Arch Physiother. 2025 May 12;15:97-109. doi: 10.33393/aop.2025.3256. eCollection 2025 Jan-Dec.
The cervical spine's role in shoulder pain remains unclear, particularly regarding its influence on shoulder pain severity and functional limitations. This study aimed to compare neck mobility, pain sensitivity, and strength between patients with rotator cuff-related shoulder pain (RCRSP) and asymptomatic controls and to explore associations between neck active range of motion (AROM) and shoulder outcomes.
A cross-sectional study was conducted with 50 patients with RCRSP and 50 asymptomatic controls. Neck AROM was measured with a CROM device, pressure pain thresholds (PPTs) with a digital algometer, and isometric neck strength with a handheld dynamometer. Shoulder pain and disability were assessed using the Visual Analog Scale (VAS) and the Shoulder Pain and Disability Index (SPADI).
Compared to controls, patients with RCRSP exhibited reduced neck rotation toward the affected shoulder (mean difference: -5.19°; 95% CI: -8.84 to -1.38) and lower PPTs bilaterally (affected side: -1.49 kg/cm²; 95% CI: -1.99 to -1.00; unaffected side: -1.42 kg/cm²; 95% CI: -1.98 to -0.91). No differences were found in neck strength. Regression analysis showed that greater neck flexion, lateral flexion toward the affected side, and reduced protraction were associated with higher SPADI scores. Additionally, neck lateral flexion and rotation toward the affected side were negatively associated with shoulder pain intensity over the last week.
These findings suggest a potential interaction between the cervical spine and shoulder in RCRSP, underscoring the importance of a comprehensive assessment of both cervical and shoulder impairments in this condition.
颈椎在肩部疼痛中的作用仍不明确，尤其是其对肩部疼痛严重程度和功能受限的影响。本研究旨在比较肩袖相关肩部疼痛（RCRSP）患者与无症状对照组之间的颈部活动度、疼痛敏感性和力量，并探讨颈部主动活动范围（AROM）与肩部预后之间的关联。
对50例RCRSP患者和50例无症状对照组进行了横断面研究。使用CROM装置测量颈部AROM，使用数字压力痛觉计测量压力痛阈（PPTs），使用手持测力计测量等长颈部力量。使用视觉模拟量表（VAS）和肩部疼痛与功能障碍指数（SPADI）评估肩部疼痛和功能障碍。
与对照组相比，RCRSP患者向患侧肩部的颈部旋转减少（平均差异：-5.19°；95%CI：-8.84至-1.38），双侧PPTs较低（患侧：-1.49kg/cm²；95%CI：-1.99至-1.00；未患侧：-1.42kg/cm²；95%CI：-1.98至-0.91）。颈部力量未发现差异。回归分析表明，更大的颈部前屈、向患侧的侧屈以及减少的前伸与更高的SPADI评分相关。此外，颈部向患侧的侧屈和旋转与过去一周的肩部疼痛强度呈负相关。
这些发现提示在RCRSP中颈椎和肩部之间可能存在相互作用，强调了在此情况下对颈椎和肩部损伤进行全面评估的重要性。
