Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain – a cross-sectional study

Abstract Background It is theorized that neck pain may cause reduced postural control due to the known physiological connection between the receptors in the cervical spine and the vestibular system. The purpose of this study was to examine whether the pressure pain threshold in the neck is associate...

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Main Authors: Mari K. Knapstad, Frederik K. Goplen, Tove Ask, Jan S. Skouen, Stein Helge G. Nordahl
Format: Article
Language:English
Published: BMC 2019-11-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12891-019-2922-4
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spelling doaj-e13ea7a9966e448e813b5e31dfe8fb2e2020-11-25T04:08:42ZengBMCBMC Musculoskeletal Disorders1471-24742019-11-012011910.1186/s12891-019-2922-4Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain – a cross-sectional studyMari K. Knapstad0Frederik K. Goplen1Tove Ask2Jan S. Skouen3Stein Helge G. Nordahl4Norwegian National Advisory Unit on Vestibular Disorders, Department of Otorhinolaryngology & Head and Neck Surgery, Haukeland University HospitalNorwegian National Advisory Unit on Vestibular Disorders, Department of Otorhinolaryngology & Head and Neck Surgery, Haukeland University HospitalDepartment of Physical Therapy, Haukeland University HospitalDepartment of Physical Medicine and Rehabilitation, The Outpatient Spine Clinic, Haukeland University HospitalNorwegian National Advisory Unit on Vestibular Disorders, Department of Otorhinolaryngology & Head and Neck Surgery, Haukeland University HospitalAbstract Background It is theorized that neck pain may cause reduced postural control due to the known physiological connection between the receptors in the cervical spine and the vestibular system. The purpose of this study was to examine whether the pressure pain threshold in the neck is associated with postural sway in patients with dizziness or neck pain. Methods Consecutive patients with dizziness (n = 243) and neck pain (n = 129) were recruited from an otorhinolaryngological department and an outpatient spine clinic, respectively. All subjects underwent static posturography. Pressure pain thresholds were measured at four standardized points in the neck, and generalized pain was assessed using the American College of Rheumatology tender points. The relationship between postural sway and pressure pain threshold was analyzed by linear regression, and the covariates included age, sex, and generalized pain. Results In the dizzy group, there was a small, inverse relationship between pressure pain thresholds and sway area with eyes closed, after adjusting for age, sex, and generalized pain (bare platform; lower neck, p = 0.002, R 2  = 0.068; upper neck, p = 0.038, R 2  = 0.047; foam rubber mat; lower neck, p = 0.014, R 2  = 0.085). The same inverse relationship was found between pressure pain thresholds in the neck and the Romberg ratio on a bare platform after adjusting for age, sex and generalized pain (upper neck, p = 0.15, R 2  = 0.053; lower neck, p = 0.002, R2 = 0.069). Neither of these relationships were present in the neck pain group. Conclusion Our findings indicate that the pressure pain threshold in the neck is associated with postural sway in patients suffering from dizziness after adjusting for age, sex, and generalized pain, but only with closed eyes. The association was small and should be interpreted with caution. Trial registration Trial registration: Clinicaltrial.gov NCT03531619. Retrospectively registered 22 May 2018.http://link.springer.com/article/10.1186/s12891-019-2922-4PosturographyNeck painDizziness
collection DOAJ
language English
format Article
sources DOAJ
author Mari K. Knapstad
Frederik K. Goplen
Tove Ask
Jan S. Skouen
Stein Helge G. Nordahl
spellingShingle Mari K. Knapstad
Frederik K. Goplen
Tove Ask
Jan S. Skouen
Stein Helge G. Nordahl
Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain – a cross-sectional study
BMC Musculoskeletal Disorders
Posturography
Neck pain
Dizziness
author_facet Mari K. Knapstad
Frederik K. Goplen
Tove Ask
Jan S. Skouen
Stein Helge G. Nordahl
author_sort Mari K. Knapstad
title Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain – a cross-sectional study
title_short Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain – a cross-sectional study
title_full Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain – a cross-sectional study
title_fullStr Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain – a cross-sectional study
title_full_unstemmed Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain – a cross-sectional study
title_sort associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain – a cross-sectional study
publisher BMC
series BMC Musculoskeletal Disorders
issn 1471-2474
publishDate 2019-11-01
description Abstract Background It is theorized that neck pain may cause reduced postural control due to the known physiological connection between the receptors in the cervical spine and the vestibular system. The purpose of this study was to examine whether the pressure pain threshold in the neck is associated with postural sway in patients with dizziness or neck pain. Methods Consecutive patients with dizziness (n = 243) and neck pain (n = 129) were recruited from an otorhinolaryngological department and an outpatient spine clinic, respectively. All subjects underwent static posturography. Pressure pain thresholds were measured at four standardized points in the neck, and generalized pain was assessed using the American College of Rheumatology tender points. The relationship between postural sway and pressure pain threshold was analyzed by linear regression, and the covariates included age, sex, and generalized pain. Results In the dizzy group, there was a small, inverse relationship between pressure pain thresholds and sway area with eyes closed, after adjusting for age, sex, and generalized pain (bare platform; lower neck, p = 0.002, R 2  = 0.068; upper neck, p = 0.038, R 2  = 0.047; foam rubber mat; lower neck, p = 0.014, R 2  = 0.085). The same inverse relationship was found between pressure pain thresholds in the neck and the Romberg ratio on a bare platform after adjusting for age, sex and generalized pain (upper neck, p = 0.15, R 2  = 0.053; lower neck, p = 0.002, R2 = 0.069). Neither of these relationships were present in the neck pain group. Conclusion Our findings indicate that the pressure pain threshold in the neck is associated with postural sway in patients suffering from dizziness after adjusting for age, sex, and generalized pain, but only with closed eyes. The association was small and should be interpreted with caution. Trial registration Trial registration: Clinicaltrial.gov NCT03531619. Retrospectively registered 22 May 2018.
topic Posturography
Neck pain
Dizziness
url http://link.springer.com/article/10.1186/s12891-019-2922-4
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