Deep Cervical Muscle Dysfunction and Head/Neck/Face Pain, Part 2
by Howard W. Makofsky, PT, DHSc and Leonard B. Goldstein, DDS, PhD
 Neck pain can be a disabling disorder characterized by periods of
remission and exacerbation. It is estimated that in any 6-month period, 54% of adults will
experience neck pain.1 There is evidence in the modern literature that changes
in deep cervical (neck) muscle (longus capitis, rectus capitis anterior, rectus capitis
lateralis, and longus colli) function, as measured by EMG, are associated with neck
disorders.2 These changes indicate a reorganization of the motor strategy to
perform specific tasks such that neck pain is associated with disturbed neural control of
the cervical muscles. These impairments in deep cervical muscle function may result in
heightened activity of the superficial muscles (e.g., sternocleidomastoids and anterior
scalenes) during craniocervical flexion and upper limb movements.1 Although
many muscles of the neck contribute to stabilization and protection of the cervical spine,
the deep cervical flexors are critical for the control of intervertebral motion and
control of the cervical lordosis.3 The importance of training the core
stabilizers in the lumbar spine has been accepted for some time,4 but the
importance of core stability in the cervical spine is relatively new. As reported in Part
I, cervical dysfunction may be seen in up to 70% of the population suffering from any type
of recurring headache.5
In recent years, there has been an increase in the investigation of cervical motor
impairment associated with headaches. It is known that cervicogenic headache sufferers
present with many neuromuscular changes that are different from those suffering from neck
pain only.6 In addition, reduced range of motion is a criterion for
cervicogenic headache but not for migraine or tension-type headache.7,8,9
Please refer to the October 2009 issue for the complete text. In the event you need to order a back issue, please click here.
— October 2009
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