Background Chronic neck pain (CNP) causes the disruption of the thoracic region and the shoulder girdle biomechanics besides the cervical region.The shoulder capsule is often thickened in shoulder problems, which causes shoulder tightness. In the literature, the effect of CNP on shoulder tightness was not investigated.

Objectives The purpose of this study is to investigate the posterior shoulder tightness (PST) in patients having CNP and to interpret the effect of patients functional level and posture.

Methods Non-specific CNP patients (n=16, female) and healthy subjects (n=16, female) were included and no shoulder problem was identified. The severity of the pain with Visual Analogue Scale (VAS); PST with bubble inclinometer; functional disability level with Neck Disability Index (NDI); influence of posture with New York Postural Rating Scale (NYPRS), upper limb muscle strength evaluated with handgrip. The Mann-Whitney U test Pearson correlation analysis was used to determine the relationship between PST and functional disability levels.

Results Age and BMI values of healthy subjects and patients with CNP were similar (p>0.05). The mean duration of disease in patients with CNP was 60.63±35.37 months. Patients with CNP had lower PST values than healthy subjects, namely shoulder tightness is more than healthy subjects (p<0.001). The functional disability level score was higher in patients with CNP than in healthy subjects (p<0.001). NYPRS scores were lower in patients with CNP than in healthy subjects, namely the posture was more adversely affected in these patients (p<0.001). Handgrip values were lower and he pain severity at rest and activity was significantly higher in patients with CNP than in healthy subjects (p<0.001, Table 1). PST correlated well with the NYPS value (r=−0.56, p=0.03) and functional disability level (r=−0.63, p<0.001) in patients with CNP.

Conclusions Pain and upper limb muscle strength loss due to problem in patients with CNP, adversely affect patients‘ posture and reduce their functional levels. For these reasons, it is suggested that the shoulder girdle should be evaluated besides the neck area in the treatment of patients having CNP and treatment should be included with appropriate physiotherapy and exercise program from the early period.

Reference [1] Kolber MJ, et al. The reliability, minimal detectable change and construct validity of a clinical measurement for identifying posterior shoulder tightness. N Am J Sports Phys Ther, 2010;5: 208–19.

Disclosure of Interest None declared