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Predicting persistent neck pain: a 1-year follow-up of a population cohort
Jonathan Hill1, Martyn Lewis, Ann C Papageorgiou
1Primary Care Sciences Research Centre, Keele University, Staffordshire, UK. j.hill@keele.ac.uk
Study Design:
A population cohort study to determine the 1-year persistence of neck pain.
Objectives:
The aim of this study was to determine the persistence of neck pain over a 12-month period among the general adult population and to explore socio-demographic, health-related, occupational, physical, and lifestyle factors that might be linked to such persistence.
Summary Of Background Data:
Musculoskeletal clinicians report that neck patients frequently return to consult for recurring episodes of pain. However, the persistent nature of neck pain has been less researched than other common chronic pain syndromes.
Methods:
First, to identify a cohort of current neck pain sufferers, a baseline cross-sectional survey was conducted in a general population of 7,669 adults, 18 to 75 years of age, registered with two primary care practices in South Manchester, UK. The second phase was a follow-up survey, 12 months later, to determine the 1-year persistence of neck pain among those who had reported neck pain at baseline. Persistence of neck pain was compared across groups of responders stratified by potential prognostic factors measured at baseline. "Persistent" neck pain was defined according to shading within the region of the neck on a blank body mannequin. The term "persistent" neck pain could therefore reflect chronic, recurrent, or continuous pain.
Results:
There were 1,359 neck pain responders in the baseline survey, and these subjects formed the study population for the prospective study. At follow-up, 786 (58%) subjects responded, of whom 48% reported having neck pain lasting for more than 1 day, during the previous month. Significant baseline characteristics, which independently predicted persistent neck pain, were age (odds ratio [OR] = 3.4), being off work at the time of the baseline survey (OR = 1.6), comorbid low back pain (OR = 1.6), and cycling as a regular activity (OR = 2.4).
Conclusion:
Among the general population, neck pain persists at 12 months in around half of those who report neck pain at the start of the period. An increased risk of persistent neck pain was associated with age 45 to 59 years and low back pain, and also with cycling. The link with psychological distress and the absence of a link with occupational factors compares with other previous findings for common musculoskeletal syndromes in the community.
