title: Investigating neck pain in wheelchair users.
abstract: OBJECTIVE
  Despite the fact that wheelchair users are exposed to risk factors for neck and upper back pain (NP), little is known about the impact and possible diagnoses associated with NP. The purpose of this study was to examine the significance of NP in wheelchair users and to determine if a portion of the NP may be myofascial in origin.
  
  
  METHODS
  Cross-sectional cohort study using questionnaires and physical exams to evaluate NP in a convenience sample of wheelchair users from the National Veteran's Wheelchair Games. Main outcome measures included reported NP, visual analog scale of neck complaints, Neck Disability Index, and physical examination findings of trigger points.
  
  
  RESULTS
  Sixty-six percent of subjects reported NP since becoming a wheelchair user and, 60% reported pain during the past month. Neither age nor length of time in a wheelchair was significantly different between those subjects who did and those subjects who did not report pain. Of those respondents who reported NP, 60% visited the doctor about the pain and 40% limited their daily activities due to the pain. Trigger-point palpation reproduced pain in 54% of those respondents who experienced pain in the past month (n = 34).
  
  
  CONCLUSIONS
  This study provides a first step in defining the prevalence and significance of NP among wheelchair users. Clinicians who work with this population need to ask subjects about symptoms and consider a myofascial origin for that pain when considering treatment.
authors.affiliation: Human Engineering Research Laboratories, Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pennsylvania 15206, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Boninger
authors.forename: Rory A
authors.initials: RA
authors.lastname: Cooper
authors.forename: Shirley G
authors.initials: SG
authors.lastname: Fitzgerald
authors.forename: Jessica
authors.initials: J
authors.lastname: Lin
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Cooper
authors.forename: Brad
authors.initials: B
authors.lastname: Dicianno
authors.forename: Betty
authors.initials: B
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000209:etiology / Q000628:therapy; D019547:Neck Pain / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D017063:Outcome Assessment, Health Care; D010173:Palpation; D015995:Prevalence; D014910:Wheelchairs / Q000009:adverse effects*