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Pilates for Neck & Shoulder Pain: a look into my Masters Thesis

So here it is...I mentioned in my post on International Pilates Day that I would share a more in depth look into my Masters Thesis, which looked at the effects of a 9 week Pilates intervention on neck, shoulder & upper back pain in female office workers. Pilates has gained popularity in the rehabilitation world for it's beneficial treatment and management of lower back pain, so it was time to see how we can use this method of exercise to translate these positive impacts to neck, shoulder & upper back pain.

Introduction

Studies have shown that the amount of time spent in front of the computer by female office workers has led to increased pain in their neck, shoulders and upper back. The main risk factors identified include being female, as well as poor posture and static muscle contractions adopted during visual display unit (VDU) work. Research suggests that this increase in upper extremity pain is becoming a growing concern amongst employers; specifically due to the associated negative socioeconomic consequences; such as decreased worker productivity, the inability to perform job tasks and increased workers compensation costs. The significance of this problem warranted an investigation into identifying an appropriate exercise intervention that is efficient in relieving upper extremity pain in female office workers; further motivated by the fact that sufficient evidence has emerged to support the effectiveness of exercise therapy in treating and preventing neck, shoulder and/or upper back pain in office workers.

Studies have shown that prolonged computer use by female office workers has led to increased pain in their neck, shoulders and upper back. The main risk factors include being female, poor posture and static muscle contractions adopted during visual display unit (VDU) work. These altered muscle recruitment patterns in turn result in decreased neck and shoulder muscle strength. Together, these factors play a role in the development of neck and shoulder pain in office workers.

Literature promotes the use of exercise therapy to effectively treat and prevent neck and shoulder pain in office workers by targeting the causative factors, such as correcting poor posture and improving neck and shoulder muscle strength. However, further research is required to identify which type of exercise is effective and appropriate for office workers in relieving musculoskeletal pain symptoms.

One possible mode of exercise to investigate is Pilates. Pilates is defined as a mind-body exercise that focuses on strength, core stability, flexibility, muscle control, posture and breathing. Pilates has been identified as an exercise method promoting stabilisation and rehabilitation. One study have shown that Pilates can improve upper spine posture, amongst other aspects, whilst another reported significant improvements in shoulder flexibility and mobility after 16-weeks Pilates training intervention period. These results warranted an investigation into the effects of Pilates on upper spine musculature and associated neck, shoulder and/or upper back pain.

Methods

An experimental, pre-test post-test control group design was used. Female office workers between 30-55 years (n=60) performing ≥4hrs of VDU work per day with pain in their neck, shoulders and/or upper back, volunteered for the study. Participants were randomly assigned to a control group (CG) (n=30) or experimental group (EG) (n=30), using the fishbowl technique. The EG completed 18 Pilates sessions over nine weeks. Baseline and post-intervention measurements included pain prevalence (Nordic Musculoskeletal Questionnaire); pain intensity (Visual Analogue Scale); scapular stability (lateral scapular slide test), neck and shoulder range of motion (ROM) and shoulder strength (MicroFET3 digital inclinometer and dynamometer). Statistical analysis included paired t-tests, unpaired t-tests and effect sizes.

9 week Pilates progression intervention programme

Results

Pain prevalence

At post-test the EG reported a reduction in pain prevalence in the neck (46.67%), shoulders (66.67%) and upper back (33.33%). Baseline pain intensity values averaged at 5.4, with a significant 33.3% decrease following the intervention.

Range of motion (ROM)

The most restricted ROMs were neck rotation, neck lateral flexion, shoulder flexion, shoulder abduction and shoulder internal rotation (IR). Significant post-intervention improvements were noted in neck flexion, neck extension, neck lateral flexion, neck rotation to the right, shoulder extension, left shoulder flexion, shoulder abduction and left shoulder external rotation (ER).

Shoulder strength

Shoulder flexion, extension and abduction strength values were below the norms at baseline. The Pilates intervention significantly increased left shoulder flexion, shoulder extension, right shoulder abduction, shoulder IR, shoulder ER.

Scapular stability

Scapular instability at baseline improved significantly at post-test.

Conclusion

The Pilates intervention successfully:

- reduced neck, shoulder & upper back pain prevalence and intensity

- increased neck and shoulder ROM with variable clinical significance

- increased shoulder strength with variable clinical significance

- improved scapular stability

So the results found in my Masters Thesis supports the use of Pilates to manage and treat neck, shoulder & upper back pain. Just another proven benefit of this fantastic method of exercise. If you still haven't given Pilates a try, you're missing out! Book your first session today :)


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© 2020 by Kim Decina Biokineticist