IS NECK PAIN THE EFFECT OF ANKLE INSTABILITY?

Abstract

Introduction: The myofascial chains concept along with tensions and disruptions analysis in chain connectivity contribute to neck pain understanding. Moreover, this concept justifies the existence of other causes, not just local impairements, that promote and maintain cervical dysfunctions. Objective: This study aims to investigate the correlation between neck disability and ankle instability by analyzing the relationships between Neck Disability Index (NDI) and Numeric Rating Scale (NRS) with Cumberland Ankle Instability Tool (CAIT) and Y Balance Test (YBT). Material and Methods: 60 participants were assessed for ankle instability using CAIT and dynamic postural control through YBT. Cervical disability and pain intensity were quantified using NDI and NRS, respectively. Correlation analyses were performed to identify associations between distal (ankle) and proximal (cervical) parameters. Results: The analysis revealed a very strong positive correlation between NDI and pain intensity (r-0.884, p= 0.000), a strong significant negative correlation was observed between NDI and CAIT (r= -0.595, p= 0.000). Moderate negative correlations were found between NDI and Y Balance Test scores for the both the right (r= -0.407, p= 0.001) and left limbs (r= -0.406, p= 0.001). In addition, pain intensity showed moderate negative correlations with CAIT scores (r= -0.567, p=0.000), and with Y Balance test (r= -0.464, p=0.001 for right limb and r= -0.389, p=0.002 for the left limbs). Discussion: Preliminary findings indicate that reduced ankle stability and lower YBT scores are associated with higher levels of cervical disability and pain. Most participants reported a good ankle stability based on CAIT scores, their performance on the Y Balance Test indicated reduced dynamic balance. This discrepancy may be explained by the subjective nature of CAIT questionnaire which reflects individual’s perception of stability rather than objective neuromuscular control. Chronic ankle instability can often be compensated for by other postural segments, leading to a false sense of stability. Conclusions: The observed correlations suggest that impaired ankle function may contribute to altered cervical motor control and discomfort through global myofascial and neuro-sensory mechanisms. A global assessment and treatment approach, addressing both distal and proximal components could improve outcomes in subjects with cervical dysfunction.