The impact of neck pain and movement performance on the interarticular compressive force of the cervical spine: a cross-sectional study based on OpenSim.
Jinjing Hu, Xiangping Li, Peng Zheng and 10 others
PMID 39934818WHAT IT FOUND
People with chronic neck pain experienced higher simulated compressive forces in their cervical spine during movement than healthy controls, despite similar range of motion.
Stronger neck muscle strength was linked to lower compressive forces, supporting the theoretical basis for strengthening exercises.
Key findings
01Simulated interarticular compressive force in the neck pain group was consistently higher than in the asymptomatic group across all segments and movements.
02Maximum voluntary isometric contraction (muscle strength) was negatively correlated with peak compressive force, suggesting stronger muscles reduce spinal load.
03There was no significant difference in the overall range of motion between the neck pain group and the control group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study is cross-sectional, so it cannot prove that neck pain causes higher compressive forces or that strengthening reduces pain; it only shows associations. The participants were relatively young (mean age ~25 years) and had mild pain (mean NRS ~3.3), so results may not apply to older adults or those with severe neck pain. Compressive forces were estimated using a computer model (OpenSim), not measured directly in the body, so accuracy depends on the model's assumptions. The model did not account for interactions between muscles or specific joint structures like facet joints, which are relevant to neck pain. Pain avoidance behavior during muscle strength testing could have influenced the MVIC results, though no participants reported increased pain after testing.
Declared interests
The authors declared no competing interests. Funding was provided by the National Natural Science Foundation of China, Natural Science Foundation of Guangdong Province, National Health Commission multi-center collaborative horizontal research project, Guangzhou Science and Technology Plan, and Southern Medical University Scientific Research Start-up Plan.
The easy way to misread this
Do not interpret the higher simulated compressive force in the neck pain group as a direct cause of their pain or as proof that strengthening will reduce pain in your specific patient. This is a cross-sectional simulation study with young, mildly affected participants; it shows an association, not causation, and does not measure actual tissue stress in living patients.