Cervical muscle volume in individuals with idiopathic neck pain compared to asymptomatic controls: A cross-sectional magnetic resonance imaging study

Suzanne J. Snodgrass, Christopher Croker, Meghana Yerrapothu, Samala Shepherd, Peter Stanwell, Carl Holder, Chris Oldmeadow, James Elliott

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Background: Neck muscle compositional changes may represent potential biomarkers contributing towards chronic neck-related pain and disability. Objectives: To determine differences in muscle volume in the cervical muscles of individuals with chronic idiopathic neck pain compared with age- and sex-matched asymptomatic individuals, and to determine if these muscle variables relate to spinal level, side (left or right), age, sex, body mass index (BMI) or muscle strength. Study design: Cross-sectional magnetic resonance imaging (MRI) study. Methods: Muscle volume of five muscle (groups) from cervical levels C3-T1 in 20 pain and 17 asymptomatic participants were quantified using MRI: levator scapulae, multifidus including semispinalis cervicis, semispinalis, splenius capitus including splenius cervicis, and sternocleidomastoid. Isometric extensor and flexor muscle strength were assessed with a dynamometer. Linear mixed modelling determined differences between groups in muscle volume accounting for participant characteristics. Results: Individuals with pain had greater muscle volume (adjusted mean difference 71.2 mm3 (95% CI 14.2–128.2, p = .015) of the sternocleidomastoid, accounting for spinal level, side, muscle group (extensors vs flexor), sex, age, body mass index and strength. Modelling indicated muscle volume differed between spinal levels (p < .001); greater extensor muscle strength was associated with greater volume (p = .011); female sex (p < .001) and older age (p = .012) were associated with less volume. Conclusion: Between-group differences in cervical flexor muscle volume, and volume differences across spinal levels and muscles suggest the contribution of cervical muscles to chronic idiopathic neck pain is multifaceted and complex.

Original languageEnglish
Article number102050
JournalMusculoskeletal Science and Practice
Publication statusPublished - Dec 2019
Externally publishedYes


  • Muscle strength
  • Muscular atrophy

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

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