Variability in pain intensity, physical and psychological function in non-acute, non-traumatic neck pain

Variability in clinical presentation among patients with neck pain disorders, in relation to symptom severity and the effect of the disorder on their physical and psychological function, has not been well documented. The present study examined the variability in pain intensity, physical and emotional or cognitive function in patients with non-acute, non-traumatic neck pain, and the extent to which these factors are associated at the time of referral for physiotherapy treatment.

The study utilized a survey of patients referred for physiotherapy treatment for non-acute, non-traumatic neck pain. Seventy-two patients (mean age 58 years; SD 15.5 years) with a symptom duration ranging from four weeks to 30 years were recruited. Each completed measures of pain intensity using a visual analogue scale, and neck-pain related disability by use of the 'Neck Pain and Disability' scale (NPAD). Frequency distributions were calculated to examine variability in pain intensity, the total NPAD score and the effect of the disorder on different aspects of physical and emotional or cognitive function. Relationships between pain intensity, and physical and psychological function, were also examined.

Pain intensity was normally distributed with a mean score of 6.3 cm (SD 2.5 cm). NPAD scores were normally distributed (mean 54.8%; SD 18%). Similar variability was noted in each of the NPAD factor scores for neck function, pain intensity, emotional or cognitive function and activities of daily living. Pain intensity was significantly (p < 0.01) correlated with the total NPAD score (r = 0.55) and with each of the four effects of neck pain represented in the NPAD sub-domains (r = 0.42-0.63). Symptom duration was not significantly correlated with pain intensity, or with the severity of disability, as reflected in the total NPAD score.

The results highlight the variability between patients with neck pain, in relation to pain intensity and the effect of the disorder on physical and psychological function. Identifying the specific effects of the neck pain disorder in individual cases is important when defining the treatment objectives and selecting measures of treatment response.