Effect of two contrasting types of physical exercise on chronic neck muscle pain

Objective. The prevalence of neck muscle pain has steadily increased and especially pain from the descending part of the trapezius muscle has been associated with monotonous work tasks such as computer work. Physical exercise is generally recommended as treatment, but it is unclear which type of training is most effective. Our objective was to determine the effectiveness of specific strength training of the painful muscle versus general fitness training without direct involvement of the painful muscle (leg bicycling) on work-related neck muscle pain. Methods. We conducted a randomized controlled trial and recruited subjects from 7 workplaces characterized by monotonous jobs (e.g., computer-intensive work). Forty-eight employed women with chronic neck muscle pain (defined as a clinical diagnosis of trapezius myalgia) were randomly assigned to 10 weeks of specific strength training locally for the affected muscle, general fitness training performed as leg bicycling with relaxed shoulders, or a reference intervention without physical activity. The main outcome measure was an acute and prolonged change in intensity of neck muscle pain (100-mm visual analog scale [VAS]). Results. A decrease of 35 mm (similar to 79%; P < 0.001) in the worst VAS pain score over a 10-week period was seen with specific strength training, whereas an acute and transient decrease in pain (5 mm; P < 0.05) was found with general fitness training. Conclusion. Specific strength training had high clinical relevance and led to marked prolonged relief in neck muscle pain. General fitness training showed only a small yet statistically significant acute pain reduction.