February 2021

Paravertebral Muscle Mechanical Properties and Spinal Range of Motion in Patients with Acute Neck or Low Back Pain: A Case-Control Study

Authors: Sandra Alcaraz-Clariana 1, Lourdes García-Luque 1, Juan Luis Garrido-Castro 2, 3, César Fernández-de-las-Peñas 4, 5, Cristina Carmona-Pérez 6, Daiana Priscila Rodrigues-de-Souza 1, Francisco Alburquerque-Sendín 1, 3


  1. Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain
  2. Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Córdoba, 14071 Córdoba, Spain
  3. Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
  4. Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
  5. Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Madrid, Spain
  6. Centro de Recuperación Neurológica de Córdoba (CEDANE), 14005 Córdoba, Spain

Journal: Diagnostics - February 2021, Volume 11, Issue 2, Article no. 352 (DOI: 10.3390/diagnostics11020352)

Our aims were to identify potential differences in muscle mechanical properties (MMPs) of cervical and lumbar tissues and in spinal range of motion (ROM) between patients with acute low back pain (LBP) or acute neck pain (NP) and healthy controls, and to identify if ROMs and MMPs are able to identify subjects among the three groups.

Clinical variables (pain, disability, fear of movement, kinesiophobia, quality of life), MMPs and ROMs were obtained in 33 subjects with acute LBP, 33 with acute NP, and 33 healthy control subjects. Between-groups differences and explanatory models to discriminate groups depending on MMPs and ROMs were calculated.

The results showed that cervical tone was higher in patients with acute NP than in controls, while cervical decrement was higher in both spinal pain groups. Patients with acute NP showed reduced cervical flexion when compared to acute LBP and control groups, and also cervical rotation, but just against controls.

Furthermore, lumbar flexion was reduced in patients with acute LBP when compared to those with acute NP. Cervical decrement was able to discriminate spinal pain individuals from controls in a multinominal regression (R2: Cox–Snell estimation = 0.533; Nagelkerke estimation = 0.600). Lumbar flexion differentiated patients with acute LBP and controls, whereas cervical flexion differentiated patients with acute NP and controls.

This study supports a tendency of the affectation of other spinal regions when only one is affected.


Keywords: myotonometry; kinematics; cervical spine; low back pain; neck pain

The presence of acute LBP and acute NP can increase tone and decrease elasticity of posterior cervical muscles, and modify ROMs in flexion and rotation, which increases the relevance of assessing these features for spinal pain syndromes in clinical settings. The tissue elasticity discriminates spinal pain individuals from controls. The ROMs in flexion can also help in discriminating between acute pain and pain-free subjects. Finally, the MMPs and ROMs show a pattern of association with age and BMI in acute spinal pain, but not with intensity and quality of pain, or disability, probably due to the short period of time (acute state) during which pain is suffered.