The Effect of Depressed Scapular Position at Rest on the Neck Pain and Function

Introduction Neck pain is a major global health problem affecting a large portion of the adult population, with a worldwide prevalence ranging from 16.7% to 75.1%. The economic burden associated with neck pain is substantial, manifested through job-related issues, absenteeism, reduced productivity, and elevated treatment costs. In the United States alone, approximately 25.5 million individuals missed an average of 11.4 working days due to neck pain in 2012, and in 2016, healthcare expenditures related to neck pain reached approximately $134.5 billion, making it one of the most costly health conditions in the country.

While pain intensity has its socioeconomic consequences, also neck dysfunction constitutes an equally important dimension of this condition. Impaired neck function has been linked to deficits in cervical range of motion, proprioception, and muscular endurance, all of which can compromise daily activities, work performance, and overall quality of life. Among the multiple biomechanical factors influencing neck pain and function, the scapular position has gained growing attention. The scapula plays a critical role in maintaining postural alignment and providing a stable base for neck and shoulder movement.

Studies have shown initial evidence that individuals with neck pain may demonstrate altered scapular alignment when compared with healthy controls, though the limited sample sizes in such studies constrain the strength of these conclusions and warrant further investigation.

Also altered scapular alignment has been associated with decreased pressure pain thresholds (PPT) in the upper trapezius region, indicating heightened sensitivity to pain. Moreover, it may alter the length-tension relationship of the upper trapezius and levator scapulae muscles, potentially compromising cervical stability and movement efficiency. Such biomechanical alterations may manifest as reduced neck functional capacity, including limited range of motion and diminished performance in daily activities.

Assessment of scapular position and its influence on the cervical region has been carried out through several approaches, including comparisons of scapular resting alignment in individuals with and without neck pain, the analysis of how altering scapular positioning affects both pain and neck function, and the evaluation of pressure pain threshold in the upper trapezius as an indicator of sensitization. Despite these efforts, the relationship between depressed scapular position at rest, neck pain, and cervical function remains insufficiently explored, highlighting the need for further research to clarify this interaction. To our knowledge, the correlation between the mean vertical scapular distance of both scapulae at rest, neck pain and cervical function is not yet investigated or studied.