Course and Prognostic Factors for Neck Pain in the General Population: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

Abstract

Study Design

Best evidence synthesis.

Objective

To undertake a best evidence synthesis on course and prognosis of neck pain and its associated disorders in the general population.

Summary of Background Data

Knowing the course of neck pain guides expectations for recovery. Identifying prognostic factors assists in planning public policies, formulating interventions, and promoting lifestyle changes to decrease the burden of neck pain.

Methods

The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) conducted a critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Findings from studies meeting criteria for scientific validity were abstracted into evidence tables and included in a best evidence synthesis.

Results

We found 226 articles on the course and prognostic factors in neck pain and its associated disorders. After critical review, 70 (31%) of these were accepted on scientific merit. Six studies related to course and 7 to prognostic factors in the general population. Between half and three quarters of persons in these populations with current neck pain will report neck pain again 1 to 5 years later. Younger age predicted better outcome. General exercise was unassociated with outcome, although regular bicycling predicted poor outcome in 1 study. Psychosocial factors, including psychologic health, coping patterns, and need to socialize, were the strongest prognostic factors. Several potential prognostic factors have not been well studied, including degenerative changes, genetic factors, and compensation policies.

Conclusion

The Neck Pain Task Force undertook a best evidence synthesis to establish a baseline of the current best evidence on the course and prognosis for this symptom. General exercise was not prognostic of better outcome; however, several psychosocial factors were prognostic of outcome.

Key words: neck pain, systematic review, epidemiology, prognosis

a Department of Public Health Sciences, School of Public Health, University of Alberta, Alberta, Canada

b the Alberta Centre for Injury Control and Research, School of Public Health, University of Alberta, Alberta, Canada

c Institute for Work and Health, Toronto, Canada

d Department of Public Health Sciences, University of Toronto, Canada

e Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

f Centre of Research Excellence in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital

g Division of Health Care Outcomes and Research, Toronto Western Research Institute, Toronto, Canada

h Department of Neurology, University of California, Irvine, CA

i Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA

j Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

k Department of Orthopaedic Surgery, Stanford University School of Medicine

l Orthopaedic Spine Center and Spinal Surgery Service, Stanford University Hospital and Clinics, Stanford, CA

m Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii, Mānoa, Honolulu, HI

‡‡‡ Department of Orthopaedic, School of Medicine and Graduate School of Arts and Science, New York University; Occupational and Industrial Orthopaedic Center (OIOC), New York University Medical Center, New York, NY

§§§ Department of Environmental Medicine, School of Medicine and Graduate School of Arts and Science, New York University; Occupational and Industrial Orthopaedic Center (OIOC), New York University Medical Center, New York, NY

¶¶¶ Program of Ergonomics and Biomechanics, School of Medicine and Graduate School of Arts and Science, New York University; Occupational and Industrial Orthopaedic Center (OIOC), New York University Medical Center, New York, NY

q Endocrinology, Analgesia and Inflammation, Merck & Co. Rahway, NJ

r Department of Medicine, University of British Columbia

s Occupational Health and Safety Agency for Healthcare in BC, British Columbia, Canada

t 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

Address correspondence and reprint requests to Linda J. Carroll, PhD, 4075, RTF, University of Alberta, Edmonton, Alberta, Canada T6G 2E1

The manuscript submitted does not contain information about medical device(s)/drug(s).

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 Carroll LJ et al. Course and prognostic factors for 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:S75-S82. Reprinted with permission from Lippincott Williams & Wilkins

PII: S0161-4754(08)00340-0

doi:10.1016/j.jmpt.2008.11.013

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