Long-term computer use can lead to muscle dysfunction and disorder

Approximately 90% of white-collar workers use computers for more than four hours per day. Over time, sitting and working at a computer can lead to a dysfunction of muscle stability and other disorders of the region, which may result in shoulder and neck pain, as well as a decreased threshold for pain. One of the main reasons for shoulder pain is hyperactivity of an upper back muscle called the upper trapezius, which results in decreased control of two other muscles and instability. To treat this muscle instability, several physical therapy interventions may be used, including manual therapy. In manual therapy, the physical therapist performs various manipulations and mobilizations on the painful area in order to bring about tissue changes that will lead to less pain. Manual therapy may, therefore, be helpful for office workers with shoulder pain, and to evaluate this possibility, a study was conducted.

Middle-aged office workers with pain serve as the study group

Individuals between the ages of 30-40 who had shoulder pain and worked on a computer for more than eight hours a day were invited to participate in the study and screened to determine if they were eligible. This process led to 38 individuals who were accepted, and then randomly assigned to either the manual therapy group or the shoulder stabilization exercise group. Both groups underwent treatment during two 40-minute sessions per week for six weeks. In the manual therapy group, the therapist applied manipulations and mobilizations to various muscles in the back, chest, and neck for three minutes each. In the shoulder stabilization group, patients were instructed to perform a series of stretching and strengthening exercises for muscles in the same area. All patients were assessed before and after undergoing treatment for pressure pain threshold (PPT) of certain muscles, which measures the minimum force applied that causes pain.

Manual therapy leads to greater improvements

After completing treatment, participants in both groups experienced significant improvements with an increased PPT of several muscles of the upper back; however, the manual therapy group showed greater PPT improvements in these muscles than the shoulder stabilization group. This is likely due to the pain-relieving properties of manual therapy, as it increases blood flow and decreases the activity of muscles in such a way that it changes the length of tissues and results in less pain. These results show that while both shoulder strengthening exercises and manual therapy appear to be effective for office workers with shoulder pain, manual therapy is even more beneficial for improving their threshold for pain. Individuals currently dealing with this type of pain should, therefore, seek out the services of a physical therapist for appropriate treatment.

-As reported in the September ’16 issue of The Journal of Physical Therapy Science

Persistence of symptoms results from both physical and psychological factors

Approximately 50% of people with whiplash-associated disorders (WADs) continue to report neck pain one year after injury, yet despite this prevalence, there is no clear evidence regarding the most effective treatment. Though exercise is considered safe and effective for neck pain, it’s efficacy for WADs specifically is unclear, and the same is true for prescribed physical activity (PPA). In addition, since the persistence of symptoms in WAD patients is due to both physical and psychological factors, a behavioral approach may also be beneficial, but this is not clear either. Based on these shortcomings, a randomized-controlled trial (RCT) was conducted to evaluate the long-term effects of neck-specific exercise on WADs.

Two-year follow-up performed on earlier RCT

The current study was a one- and two-year follow-up on a 2014 RCT. Initially, 216 individuals with grade 2 or 3 whiplash injury were recruited and randomized to the neck-specific exercise (NSE) group, the neck-specific exercise with behavioral approach (NSEB) group or the PPA group, and all interventions spanned 12 weeks. Patients in the NSE group followed a supervised neck-specific exercise program twice a week. At first, this focused on deep cervical muscles, and eventually, more progressive head resistance training was incorporated gradually. The NSEB group received the same treatments plus physical therapist-led behavioral interventions. The PPA group was prescribed general physical activity to be performed independently without any neck-specific exercises. Patients were assessed for pain, disability, functioning and other variables at baseline and then one and two years later.

Positive long-term outcomes reached with neck-specific exercises

In total, 170 patients (79%) completed the one-year follow-up and 123 (57%) completed the two-year-follow-up. At one year, both neck-specific groups displayed more clinically important improvements in pain, disability, and functioning than the PPA group. At two years, the same was true for disability, and there were also clear trends towards greater improvements in all other outcomes as well. The addition of the behavioral approach did not produce any significant differences. This follow-up RCT suggests that neck-specific exercises can lead to improvements in patients with WADs for one or two years, but additional research is needed to confirm these findings with a different study population, longer follow-up and higher retention rates.

-As reported in the March ’16 issue of the Journal of Rehabilitation Medicine