Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 2, Supplement , Pages S46-S60, February 2009

The Burden and Determinants of Neck Pain in the General Population:

Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

  • Sheilah Hogg-Johnson, PhD

      Affiliations

    • Institute for Work and Health, Toronto, Canada; and Department of Public Health Sciences, University of Toronto, Toronto, Canada
    • Corresponding Author InformationAddress correspondence and reprint requests to Sheilah Hogg-Johnson, Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, Ontario, Canada, M5G 2E9
    • ,
  • Gabrielle van der Velde, DC

      Affiliations

    • Institute for Work and Health, Toronto, Canada; Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada; Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada
    • ,
  • Linda J. Carroll, PhD

      Affiliations

    • Department of Public Health Sciences, and the Alberta Centre for Injury Control and Research, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
    • ,
  • Lena W. Holm, DrMedSc

      Affiliations

    • Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
    • ,
  • J. David Cassidy, DC, PhD

      Affiliations

    • Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada; Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada; Departments of Public Health Sciences and Health Policy, Management and Evaluation, University of Toronto, Canada
    • ,
  • Jamie Guzman, MD, MSc, FRCP(C)

      Affiliations

    • Department of Medicine, University of British Columbia, Canada; Occupational Health and Safety Agency for Healthcare in British Columbia, Canada
    • ,
  • Pierre Côté, DC, PhD

      Affiliations

    • Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada; Departments of Public Health Sciences and Health Policy, Management and Evaluation, University of Toronto, Canada; Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada; Institute for Work & Health, Toronto, Canada
    • ,
  • Scott Haldeman, DC, MD, PhD

      Affiliations

    • Department of Neurology, University of California, Irvine; Department of Epidemiology, School of Public Health, University of California, Los Angeles, California
    • ,
  • Carlo Ammendolia, DC, PhD

      Affiliations

    • Division of Health Care and Outcomes Research, Toronto Western Research Institute; Centre for Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network, Toronto, Canada; Department of Health Policy, Management and Evaluation, University of Toronto, Canada
    • ,
  • Eugene Carragee, MD, FACS

      Affiliations

    • Department of Orthopedic Surgery, Stanford University School of Medicine; Orthopedic Spine Center and Spinal Surgery Service, Stanford University Hospital and Clinics, Stanford
    • ,
  • Eric Hurwitz, DC, PhD

      Affiliations

    • Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Mānoa, Honolulu, Hawaii
    • ,
  • Margareta Nordin, PT, DrMedSc

      Affiliations

    • Departments of Orthopedics and Environmental Medicine and Program of Ergonomics and Biomechanics, School of Medicine and Graduate School of Arts and Science, New York University; Occupational and Industrial Orthopedic Center (OIOC), New York University Medical Center, New York
    • ,
  • Paul Peloso, MD, MSc,FRCP(C)

      Affiliations

    • Endocrinology, Analgesia and Inflammation, Merck & Co., Rahway, New Jersey

Abstract 

Study Design

Best evidence synthesis.

Objective

To undertake a best evidence synthesis of the published evidence on the burden and determinants of neck pain and its associated disorders in the general population.

Summary of Background Data

The evidence on burden and determinants of neck has not previously been summarized.

Methods

The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders performed a systematic search and critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Studies meeting criteria for scientific validity were included in a best evidence synthesis.

Results

We identified 469 studies on burden and determinants of neck pain, and judged 249 to be scientifically admissible; 101 articles related to the burden and determinants of neck pain in the general population. Incidence ranged from 0.055 per 1000 person years (disc herniation with radiculopathy) to 213 per 1000 persons (self-reported neck pain). Incidence of neck injuries during competitive sports ranged from 0.02 to 21 per 1000 exposures. The 12-month prevalence of pain typically ranged between 30% and 50%; the 12-month prevalence of activity-limiting pain was 1.7% to 11.5%. Neck pain was more prevalent among women and prevalence peaked in middle age. Risk factors for neck pain included genetics, poor psychological health, and exposure to tobacco. Disc degeneration was not identified as a risk factor. The use of sporting gear (helmets, face shields) to prevent other types of injury was not associated with increased neck injuries in bicycling, hockey, or skiing.

Conclusion

Neck pain is common. Nonmodifiable risk factors for neck pain included age, gender, and genetics. Modifiable factors included smoking, exposure to tobacco, and psychological health. Disc degeneration was not identified as a risk factor. Future research should concentrate on longitudinal designs exploring preventive strategies and modifiable risk factors for neck pain.

Key words: neck pain, epidemiology, incidence, prevalence, risk factors, associated factors

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 The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

 Corporate/Industry, Foundation, and Professional Organizational funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

 Reprinted from Hogg-Johnson S et al. The burden and determinants of neck pain in the general population. Results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine 2008;33:S39-S51. Reprinted with permission from Lippincott Williams & Wilkins.

PII: S0161-4754(08)00337-0

doi:10.1016/j.jmpt.2008.11.010

Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 2, Supplement , Pages S46-S60, February 2009

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