October 2022

Cervical and scapula-focused resistance exercise program versus trapezius massage in patients with chronic neck pain: A randomized controlled trial

Authors: Taewoo Kang 1, Beomryong Kim 2


  1. Department of Physical Therapy, College of Health and Welfare, Woosuk University, Wanju, Republic of Korea
  2. Department of Physical Therapy, Design Hospital, Jeonju, Republic of Korea

Journal: Medicine - September 2022, Volume 101, Issue 39, e30887 (DOI: 10.1097/MD.0000000000030887)

Objective: The purpose of this study was to investigate the effects of resistance exercise in comparison with those of common exercise on chronic neck pain (CNP) to provide useful clinical guidelines for reducing pain or increasing cervical range of motion (ROM), upper trapezius tone, disability level, and quality of life (QOL).

Methods: The subjects were randomized into a cervical and scapula-focused resistance exercise group (CSREG, n = 21) or trapezius massage group (TMG, n = 20). All groups received a 4-week, five times per week CSRE or TM program for CNP. The visual analogue scale (VAS) score, cervical ROM, myotonometer measures (upper trapezius tone, stiffness, and elasticity), neck disability index (NDI), and short form-36 (SF-36) were identified as the primary outcomes.

Results: Within-group changes in VAS, cervical ROM, myotonometer measures, NDI, and SF-36 were significant in the CSREG and TMG (P < .05). The between-group changes in VAS, cervical rotation, myotonometer (upper trapezius tone and stiffness), NDI, and SF-36 after intervention showed significant differences between the CSREG and TMG (P < .05).

Conclusion: These results suggest that the CSRE program is effective in improving pain, cervical ROM, upper trapezius tone, disability level, and QOL in patients with CNP. More comprehensive studies with longer follow-up durations are needed to better understand the potential effects of the CSRE program in patients with CNP.


Keywords: chronic neck pain, disability, musculoskeletal disorders, quality of life, resistance exercise, trapezius tone

In this study, 41 patients with CNP with muscle imbalance around the scapulothoracic region were trained for 4 weeks. There were statistically significant differences in pain, cervical ROM, upper trapezius tone, disability level, and QOL. It was found that CSRE for weakened scapulothoracic muscles positively affected pain, disability level, and QOL in NP patients, and increased cervical ROM and decreased upper trapezius tone. Based on these results, it may be necessary to consider physical therapy in NP patients. Therefore, it is suggested to refer to the muscle strength of the weakened scapulothoracic muscles in clinical interventions for patients with NP and to apply the appropriate CSRE in parallel.