What type of study is this?

This is a Systematic Review study.

What question did this study set out to answer?

To analyze the relationship between muscle fat infiltration and various clinical outcomes in neck pain.

January 14, 2026PM&R0 citationsOpen Access

Muscle fat infiltration and its relation with pain intensity, disability, and cervical curvature in individuals with nonspecific neck pain: A systematic review study

HAHardianty Andi Munawarah Abduh HKHironobu KurumaTokyo Metropolitan University TOTakuya OtsukaTokyo Metropolitan University

Key Points

To analyze the relationship between muscle fat infiltration and various clinical outcomes in neck pain.
Conducted a systematic review of literature
Included studies used structural medical imaging
Focused on populations with nonspecific neck pain lasting over three months
Examined correlational analyses between MFI and pain intensity, disability, cervical alignment.
Higher muscle fat infiltration correlates with greater disability in individuals with neck pain.
Inconsistencies found regarding MFI's relationship with cervical alignment.
Variability in imaging methods contributed to heterogeneity in outcomes.

Abstract

Abstract Objective To review and analyze the association between muscle fat infiltration (MFI) and pain intensity, disability, and cervical alignment in individuals with nonspecific neck pain. Type Systematic review study. Literature Survey Nonspecific neck pain is associated with muscular changes, including fatty infiltration, which may contribute to chronic symptoms and functional limitations. Prior studies have examined morphological muscle changes across various neck pain populations; however, specific evidence regarding the relationship between MFI and clinical outcomes in nonspecific neck pain remains limited and inconsistent. Methodology A systematic search of the Web of Science, PubMed, MEDLINE, and CINAHL databases was performed. This analysis included analytical cross‐sectional studies published from 2003 to May 2025 that used structural medical imaging to examine fatty infiltration of neck muscles in participants aged 18‐65 years with nonspecific neck pain lasting >3 months. Only articles written in English that were accessible to the authors were considered. Studies were excluded if they did not meet any of the aforementioned criteria. Synthesis Across included studies (n=4), higher MFI in cervical extensor muscles was consistently associated with greater pain intensity and disability. Evidence for a relationship between MFI and cervical alignment was inconsistent, with some studies reporting a negative association between MFI and cervical lordosis, while others found no correlation. Variability in imaging methods and clinical measures contributed to heterogeneity between studies. Conclusion The study results suggest a correlation between fatty infiltration and nonspecific neck pain features, such as pain level and neck disability, whereas cervical lordosis does not appear to be correlated. These findings highlight the importance of rehabilitation programs to reduce MFI and enhance muscle functions, which may alleviate symptoms.

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