Myofascial pain syndrome and dysfunction of the muscles that support the upper spine and shoulders can lead to a variety of symptoms in these regions, including neck pain. The reasons neck pain develops are complex and often difficult to pinpoint, but research has shown that posture and muscle activation patterns are potential risk factors.

Patients with chronic neck pain—meaning pain lasting more than three months—have been found to display differences in the way muscles like the trapezius, levator scapulae, and rhomboids behave. These patients also have less muscle strength and activity than healthy individuals. Therefore, exercises that strengthen and stabilize these muscles to regulate their activity are recommended for patient with chronic neck pain, but the amount of research on this topic is limited. For this reason, a study was conducted to evaluate the effectiveness of various strengthening and stabilization exercises for patients with chronic neck pain.

Three groups of patients assessed before and after 6–week interventions

For the study, patients with neck pain for at least three months were recruited and screened to determine if they were eligible. This led to 72 patients being included, who were randomly assigned to one of three groups: the neck exercise training group, combined training group, or the control group. In the neck exercise training group, patients completed a training program under the guidance of three physical therapists 3 days per week for 6 weeks, with each session lasting 40–60 minutes. The program consisted of three strengthening and stretching exercises that targeted the muscles of the neck.

In the combined training group, patients completed the neck exercise training program plus a scapular stabilization training program. The scapular stabilization training program included 7 strengthening and stretching exercises that targeted muscles in the scapular region that are associated with chronic neck pain.

Patients in the control group participated in a session in which they were taught a home exercise program that mainly instructed them on proper body posture for daily activities like lifting, pressing, and pulling tasks, as well as office ergonomics. All patients were assessed before and after completing these interventions with various outcome measures, including pain, neck range of motion, scapula downward rotation index (SDRI), and forward head angle (FHA). SDRI and FHA are used to assess posture and muscular dysfunction in the upper spine and torso region.

Results showed that pain, SDRI, and FHA decreased in both the neck exercise training group (except SDRI) and combined training group. Neck range of motion also increased significantly in the combined training group. Overall, patients in both the neck exercise training group and combined training group improved compared to the control group, but the combined training group reported significantly greater improvements than the neck exercise training group. Therefore, this study suggests that both neck exercises and scapular stabilization exercises is beneficial for patients with chronic neck pain, and combining these two interventions can lead to even greater benefits in pain, flexibility, and posture.

If you’re dealing with myofascial pain syndrome, chronic neck pain, or any other movement–related issues, we strongly urge you to consider scheduling an appointment with one of our physical therapists, who can diagnose your condition and get you started on a comprehensive rehabilitation program right away.