Neural and muscular factors associated with motor impairment in neck pain

Clinical neck pain is associated with impairment of muscle performance, assessable at a functional level. Functional deficiencies reflect altered mechanisms of muscle control and changed muscle properties. The basic physiologic mechanisms of pain have been extensively investigated, and the functional impairments associated with neck pain are well documented. However, the cause-effect relationships between neck pain and motor control are poorly understood, due to difficulty translating basic physiologic findings into the complex scenario of clinical pain conditions. This article reviews current evidence of disturbances in neural control and muscle properties associated with neck pain and discusses their interrelationships. Although the links among pain, motor control, and muscle properties have been established, their relative significance for the perpetuation and recurrence of neck pain remains largely unexplored. Rehabilitation programs that include interventions for neuromuscular changes seem beneficial for restoring motor function and may prove effective for reducing neck pain recurrence.