title: Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain.
abstract: BACKGROUND
  Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain.
  
  
  METHODS
  Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years) with nonspecific neck/shoulder pain for a duration of at least 30 days during the previous year and a pain intensity of at least 2 on a modified VAS-scale of 0-10 participated. Exclusion criteria were traumatic injuries or other serious chronic disease. Using a standardized finger pressure of 2 kg, palpable tenderness were performed of eight anatomical neck/shoulder locations in the left and right side on a scale of 'no tenderness', 'some tenderness' and 'severe tenderness'.
  
  
  RESULTS
  In women, the levator scapulae, neck extensors and infraspinatus showed the highest prevalence of severe tenderness (18-30%). In comparison, the prevalence of severe tenderness in the upper trapezius, occipital border and supraspinatus was 13-19%. Severe tenderness of the medial deltoid was least prevalent (0-1%). In men, the prevalence of severe tenderness in the levator scapulae was 13-21%, and ranged between 0-8% in the remainder of the examined anatomical locations.
  
  
  CONCLUSIONS
  A high prevalence of tenderness exists in several anatomical locations of the neck/shoulder complex among adults with nonspecific neck/shoulder pain. Future research should focus on several neck/shoulder muscles, including the levator scapulae, neck extensors and infraspinatus, and not only the upper trapezius.
  
  
  BACKGROUND
  ISRCTN60264809.
authors.affiliation: National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark. LLA@NRCWE.DK
authors.forename: Lars L
authors.initials: LL
authors.lastname: Andersen
authors.forename: Klaus
authors.initials: K
authors.lastname: Hansen
authors.forename: Ole S
authors.initials: OS
authors.lastname: Mortensen
authors.forename: Mette K
authors.initials: MK
authors.lastname: Zebis
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology / Q000503:physiopathology; D019547:Neck Pain / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D010147:Pain Measurement; D010173:Palpation; D010808:Physical Examination; D011237:Predictive Value of Tests; D015995:Prevalence; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012782:Shoulder / Q000473:pathology / Q000503:physiopathology; D020069:Shoulder Pain / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology