Association between Clinical and Neurophysiological Outcomes in Patients with Mechanical Neck Pain and Whiplash-associated Disorders

Matteo Castaldo, Antonella Catena, Alessandro Chiarotto, Jorge H. Villafañe, Cesar Fernández-De-Las-Peñas, Lars Arendt-Nielsen*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

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Objectives: To investigate the association between pain, disability, trigger points (TrPs), and pressure pain thresholds (PPTs) in patients with mechanical neck pain (MNP) or whiplash-associated disorders (WAD). Materials and Methods: In total, 46 MNP and 51 WAD patients underwent a physical examination consisting of cervical range of motion, PPTs in the upper trapezius and tibialis anterior muscles, TrPs examination in the upper trapezius, and collection of clinical data including disability, pain intensity, and spontaneous symptomatic pain area. Results: A significantly moderate positive association between pain and disability was found in both groups (P<0.01). Significantly negative associations between pain intensity and PPT in the upper trapezius (P=0.008 and 0.041), pain and PPT in tibialis anterior (P=0.015 and 0.038), disability and PPT in upper trapezius (both, P=0.006) were also found in both MNP and WAD groups. Individuals with MNP showed significantly positive association between pain area and disability (P=0.034) and negative association between disability and PPT in the tibialis anterior (P=0.003). Patients with active TrPs in the upper trapezius exhibited higher intensity of neck pain, higher neck disability, and lower PPTs than those with latent TrPs in upper trapezius in both groups. Discussion: The association between pain, disability, and PPTs is common in patients with neck pain regardless of the origin of neck pain. The presence of active TrPs was related to higher pain intensity and related-disability and lower PPTs.

Original languageEnglish
Pages (from-to)95-103
Number of pages9
JournalClinical Journal of Pain
Issue number2
Publication statusPublished - Feb 2018


  • disability
  • neck pain
  • pain
  • trigger points
  • whiplash


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