Neck Pain, Proprioception, and Movement Control

Can you remember when you did not think about backaches and pain in your neck, legs, shoulders? When you were younger? What about now? What has changed over time? Episodes of back pain inhibits movement control and as a result you are likely to experience more spine-related pain.

Current research and studies highlighting the role of proprioception dysfunction (kinaesthesia/position sense of limbs and body) and the connection between neck pain. The cervical spine integrates visual, balance, and position sense to create head and neck movements.

1. The Visual System: information of the head position relative to its surroundings.

2. The Vestibular (balance) System: information of the head relative to gravity

3. Proprioceptive System: information of the head relative to the trunk

Head position awareness on the trunk is achieved with muscle spindles.

Muscle spindles interpret stretch and movement within the muscle and relay this information to the brain.

Importantly, the cervical muscle spindles also directly relay information of head and neck movement to the visual and vestibular systems.

Neck pain affects not only your quality of life, work, social, family, sports it also changes how the visual, balance and proprioceptive systems send information to the brain and consequently alters how these systems integrate. The changes to the neural network from downregulation, aka not working like it did.

The paper by Holtmann S, (1) states “Muscle spindles seem to play a dominant role as receptors for neck movements. Different ascending pathways project to the central nervous system and the signals interact with visual and vestibular stimuli.” The changes to how the muscle spindles send information to the brain can affect how you interpret balance and affect control of the eyes as we move our heads.

Simone Elsigs et.al paper in the conclusion promotes “We recommend the assessment of different aspects of sensorimotor ability, even in patients with mild neck pain, to detect movement control impairment and to avoid recurrent neck pain.”

Articles akin to these compounds our understanding that it is important to be able to measure the affects of neck pain. The issue then arises how can we accurately measure cervical dysfunction related to neck pain. We can measure with computerised posturography, eye movement tracking, near far quickness, target searches, reading accuracy and comprehension etc, all these tests are data based, and progress can be tracked.

If you have recurrent neck pain, if you appreciate that to get a different result you will need a different solution, then know you have an opportunity here.

Click on the links below and see a simple exercise that help rebuild movement control.

https://youtu.be/SbaFYc6OlSE
https://youtu.be/J58QSpCUsHQ

1: Holtmann S, Reiman V. Zervikale Afferenzen und ihre Einbindung in die Gleichgewichtsregulation [Cervical afferent fibers and their relation to the regulation of equilibrium]. Laryngorhinootologie. 1989 Jan;68(1):72-7. German. doi: 10.1055/s-2007-998288. PMID: 2644505.

2: Simone Elsig, Hannu Luomajoki, Martin Sattelmayer, Jan Taeymans, Amir Tal-Akabi, Roger Hilfiker, Sensorimotor tests, such as movement control and laterality judgment accuracy, in persons with recurrent neck pain and controls. A case-control study,

Manual Therapy, Volume 19, Issue 6,2014, Pages 555-561,

David Wellington – I graduated from New Zealand College of Chiropractic and recently completed a Musculoskeletal Management Diploma from Christchurch College of Orthopedics (Otago University). My interests as I get older I am focusing falls prevention, and as I look back its to help younger patients who are having trouble reading, learning and achieving academically.
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