Restricted Cervical Range of Motion and its Association ‎with Pain Intensity in Patients with Chronic Neck Pain: An ‎Observational Study

Abstract

Background: To quantify active cervical range of motion (ROM) in patients with chronic neck pain and to examine its association with pain intensity.

Materials and Methods: In this cross-sectional study, 29 patients with chronic neck pain (22 men, 7 women; aged 20–70 years) attending private physiotherapy clinics in Zawia, Libya were assessed. Active cervical ROM in flexion, extension, lateral flexion, and rotation was measured with a universal goniometer using standardized patient positioning and landmark alignment, and pain intensity was recorded on a 10-point visual analogue scale (VAS). One-sample t-tests compared observed ROM against published reference values, and Pearson correlations examined the relationship between each movement and pain intensity (p < 0.05).

Results: All cervical movements were significantly restricted relative to reference values (all p < 0.001). Mean values were 33.6 ± 7.7° for flexion (reference 50°), 30.6 ± 6.2° for extension (reference 80°), 36.6 ± 11.5° and 36.8 ± 11.6° for right and left rotation (reference 85°), and 33.9 ± 13.2° and 32.8 ± 8.9° for right and left lateral flexion (reference 45°). Correlations between ROM and pain intensity were weak and, with one exception, non-significant; right lateral flexion showed a borderline inverse association (r = −0.345, p = 0.067).                                                

Conclusions: Cervical ROM is markedly and globally restricted in chronic neck pain. However, individual pain intensity is only weakly related to the degree of motion restriction, suggesting that restricted ROM reflects a global functional impairment rather than tracking pain severity on an individual level. ROM assessment should therefore be complemented by other clinical measures when evaluating these patients.