Ultrasonography in myofascial neck pain: randomized clinical trial for diagnosis and follow-up

Chronic neck pain (CNP) is a very prevalent condition affecting 10–24 % of the population. There is great interest regarding the role of musculoskeletal ultrasound (MSU) in the diagnosis of myofascial pain. MSU is a readily available, portable, and inexpensive imaging modality, suitable for use in a physiotherapists office to complement physical examination and to evaluate treatment outcomes. 

The aim of this study was to quantify the thickness of the deep fasciae of the neck and their sub-layers, by means of ultrasound imaging with and without CNP. This will help to document MSU as a suitable instrument for diagnosing myofascial neck pain. 

This study highlights for the first time alterations of the deep fasciae of the neck in patients with CNP and demonstrates that physiotherapy can modify fascial thickness. MSU is now considered a reliable method for visualizing fasciae and facilitating the diagnosis of myofascial pain. In particular, this research indicates that the deep neck fascia thicker than 0.15 cm overall (more than 2 standard deviations of controls) may help to make correct diagnoses of myofascial pain or non-specific pain. 

MSU indicates that the main alteration in the deep fasciae is increased loose connective tissue between the fibrous sub-layers. It is for this reason that, in indicating fascial alteration, we do not use the term ‘‘fibrosis’’, which indicates an increase in collagen fiber bundles. The authors prefer the term ‘‘densification’’, which suggests a variation in the viscosity of the fascia > From: Stecco et al, Surg Radiol Anat 36 (2014) 243–253. All rights reserved to Springer-Verlag.

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