Neck muscle stiffness measured with shear wave elastography in women with chronic non-specific neck pain

Research output: Contribution to journalArticle


  • Angela V Dieterich
  • Utku Şükrü Yavuz
  • Frank Petzke
  • Antoine Nordez
  • Deborah Falla

External organisations

  • Physiotherapy, Faculty of Health, Security, Society, Furtwangen University, Germany.
  • Biomedical Signals and Systems, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands.
  • Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany; Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology (BFNT) Göttingen, Bernstein Center for Computational Neuroscience, University Medical Center Göttingen, Georg-August University, Göttingen, Germany. Electronic address:
  • Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
  • Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.


OBJECTIVE: Utilizing shear wave elastography, we compared the stiffness of the neck extensor muscles and the stiffness in muscle-specific regions between women with chronic nonspecific neck pain and asymptomatic controls. DESIGN: Cross-sectional observational study. METHODS: We measured the average muscle stiffness over multiple neck extensor muscles and in regions corresponding approximately to the trapezius, splenius capitis, semispinalis capitis, semispinalis cervicis, and multifidus muscles using ultrasound shear wave elastography in 20 women with chronic nonspecific neck pain and 18 asymptomatic women during multiple tasks. The measurements were automatically quality controlled and computer processed over the complete visible neck region or a large muscle-specific region. RESULTS: Pooled over all tasks, neck muscle stiffness was not significantly different between those with neck pain and asymptomatic controls (neck pain median, 11.6 kPa; interquartile range, 8.9 kPa and control median, 13.3 kPa; interquartile range, 8.6 kPa; P = .175). The measure of neck muscle stiffness was not correlated with the intensity of neck pain or perceived disability. CONCLUSION: Shear wave elastography revealed similar muscle stiffness in people with and without chronic neck pain, despite the sensation of increased neck stiffness in those with chronic neck pain. Therapeutic interventions aiming to reduce neck muscle tone are often based on the assumption that perceived neck stiffness corresponds to objective muscle stiffness. The current results question this assumption.


Original languageEnglish
Pages (from-to)179-188
Number of pages10
JournalJournal of Orthopaedic and Sports Physical Therapy
Issue number4
Early online date6 Jan 2020
Publication statusPublished - Apr 2020


  • cervical spine, chronic pain, muscle tension, shear modulus, ultrasound shear wave elastography