More neck pain, less spinal mobility, altered sitting posture: Sagittal spinal alignment and mobility in women with chronic neck pain.

Background: Increasing evidence suggests that people with chronic neck pain (CNP) may display altered biomechanics beyond the cervical spine. However, whether spinal alignment and mobility are associated with neck pain is not clarified.

Objectives: To investigate whether there is a significant association between neck pain intensity and sagittal spinal alignment and mobility in people with CNP, and to examine whether sagittal spinal alignment and mobility differ according to pain intensity.

Design: A cross-sectional study.

Method: Forty-four women with CNP were included. The neck pain intensity at rest and during neck movements was assessed with the visual analogue scale (VAS). A skin-surface measurement device was used to assess sagittal alignment and mobility while sitting and standing. Linear regression analysis was used to assess associations. Participants were divided into two groups according to the pain intensity as group with mild pain (VAS≤4.4 cm) and group with moderate to severe pain (VAS>4.4 cm) and compared using the analysis of covariance.

Results: Greater resting pain was associated with a more forward trunk during sitting (Beta = 0.433, p < 0.05). Greater pain during neck movements was associated with increased lumbar lordosis during sitting (Beta = -0.376, p < 0.05). Classified by pain intensity at rest, trunk mobility while sitting was lower and forward trunk inclination and sacral kyphosis while sitting were higher in those with moderate/severe pain (η = 0.093-0.119, p < 0.05). By pain intensity during neck movements, women with moderate/severe pain exhibited lower sacral mobility while sitting (η = 0.129, p < 0.05).

Conclusions: Addressing the entire spine in the assessment and management of CNP may help reduce pain.