Additional Effects of Semispinalis Cervicis Strengthening With Craniocervical Flexion Training on Chronic Neck Pain

Detailed Description:

Chronic neck pain is persistent discomfort in the neck lasting over three months, often caused by poor posture, injury or degenerative conditions. It is the fourth-leading cause of disability worldwide, affecting 30-50% of people annually. Chronic neck pain significantly impacts quality of life, as well as physical and mental function, making it a leading cause of disability that is often challenging to manage. Common clinical symptoms include persistent neck pain, restricted neck movement, pain in the shoulders or upper limbs, migraines, muscle imbalances, and irregular breathing patterns. Chronic neck pain is often associated with a decline in the strength and endurance of deep neck muscles, particularly the deep cervical flexors (DCF) like the longus colli and longus capitis. These muscles are crucial for maintaining proper neck posture and stability. When they weaken, it can lead to poor posture and increased pain. Likewise deep neck flexors, deep cervical extensor muscles, which include the multifidus and semispinalis cervicis are also weakened in chronic neck pain patient's leading to increase pain and reduced ROMs. In response to the weakness of the deep neck muscles, the body activates superficial flexors and extensors to compensate for the loss of stability and strength. This compensatory activation is a natural response to maintain neck function and posture. However, relying on these superficial muscles can lead to over-activation, which is not ideal for long-term neck health. Exercise is essential for managing neck pain, with recent research highlighting the benefits of deep cervical muscle training. Craniocervical flexor exercises improve neuromuscular control, reduce pain, and enhance muscle activation. Likewise, deep cervical extensors like the semispinalis and multifidus play a key role in stabilization and should be targeted in rehabilitation.

Thavatchai et.al, conducted a study that shows Semispinalis cervicis strengthening outcomes benefits over usual-care outcomes for pain, cervical ROMs and functional disability.

Isha Sikka et al, conducted a study that Craniocervical Flexion training effectively reduces Neck Pain and improves functional status.

A study conducted by Ahmad H. Alghadir et.al, concluded that combining deep cervical flexor (DCF) training with conventional exercises significantly reduces pain and forward head posture (FHP) in school teachers.