Efficacy of Scapular Treatment on Chronic Neck Pain - A Systemic Review and Meta- Analysis of Randomized Trials

Abstract

Abstract Background: The treatment of chronic neck pain (CNP) is still a hot topic. This study evaluated the effects of scapular therapy in patients with CNP. Method: Databases including MEDLINE (via PubMed), EMBASE (via Ovid), Ovid, Web of Science, and Scopuswere systematically searched for randomized controlled trials published in English investigating treatments of the scapula for CNP before July 16, 2023. Result: A total of 313 participants from 8 RCTs were included. In comparison with the control groups, the intervention groups with scapular treatment showed better efficiency in improving pain intensity (SMD=2.55; 95% CI=0.97 to 4.13; P=0.002) with moderate evidence. Subgroup analysis for pain intensity revealed a significant difference between the sexes, with only the female population (SMD=6.23, 95% CI=4.80 to 7.65) showing better outcomes than those with both sexes (SMD=1.07, 95% CI=0.57 to 1.56) (p<0.00001). However, moderate evidencedemonstrated no improvement of scapular treatments on neck disability (an SMD of 0.24[-0.14, 0.62] of Neck Disability Index or Northwick Park Neck Pain Questionnaire).In addition, the pressure pain threshold seemed not to be improved, and neck functions, muscle activation status and cervical range of motioncould not be conclusively concluded due to limited support in articles, but head forward posture appeared to be corrected with moderate to low evidence. Conclusion: Scapular therapy is beneficial in improving pain intensity in patients with CNP, especially in women, but may not improve neck disability. Whether scapular therapy can improve neck muscle function and activity in patients with CNP needs further study.