Neck Pain and Exercise after an Anterior Cervical Decompression and Fusion (ACDF)
Thursday, June 3, 2010 at 11:33PMSpine surgery is an appropriate fix for some conditions. As a physiatrist I spend a lot of time helping people to avoid surgery and working on exercise interventions. Frequently I will see people after lumbar or cervical spine surgeries with neck pain and will be asked about what kinds of exercise would be appropriate or helpful.
An interesting study by Peolsson and Kjellman investigated "neck muscle endurance in patients with neck pain after anterior cervical decompression and fusion (ACDF)." [i]
Now, endurance is a noteworthy factor to look at. Studies have demonstrated that:
- Endurance exercise is considered to expedite the recovery process for patients with an acute episode of low back pain.[i]
- Endurance has been shown to be more predictive of better outcomes for back pain than other factors like “strength” or “flexibility”[iii]
- Decreased isometric back extensor endurance has been associated with the presence of LBP[iv]
With that aside, the study by Peolsson and Kjellman demonstrated that many of the patients had decreased neck muscle endurance before and after ACDF surgery. That is not surprising. Again, decreased endurance is likely a risk factor for developing spine pain. [v] What is more, after being surgerized and relatively immobilized for a period of time, muscles lose endurance.
The important finding in this study was that patients with neck pain showed improvement in pain symptoms after exercises training to specifically address neck muscle endurance. [vi] The authors concluded that “additional exercise of specific training for neck muscle endurance should be incorporated into the rehabilitation program, which may improve treatment outcome.” [vii] I would wholeheartedly agree.
There are a lot of different exercises out there that could help develop neck muscle endurance and decrease neck pain symptoms. If I were going to choose one exercise to focus on, it would be deep neck flexor training. I have a separate post at http://www.backexercisedoctor.com/journal/2009/12/7/neck-pain-generalities-and-my-favorite-neck-exercises.html#comment6860524 .
Deep Neck Flexor Activation for Neck Pain - step 2
Deep Neck Flexor Activation for Neck Pain - step 3
[i] J Manipulative Physiol Ther. 2007 Jun;30(5):343-50.
[ii] Phys Ther. 1999 Nov;79(11):1032-42
[iii] Phys Ther. 1998 Jul;78(7):754-65.
[iv] J Back Musculoskelet Rehabil. 2009;22(4):205-11.
[v] J Back Musculoskelet Rehabil. 2009;22(4):205-11.
[vi] J Manipulative Physiol Ther. 2007 Jun;30(5):343-50.
[vii] J Manipulative Physiol Ther. 2007 Jun;30(5):343-50.
Reader Comments (1)
Yes! The steps are definitely correct. Plus having some neck and back exercise will help the recovery and rehabilitation and to acquire neck and back endurance.