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Prognostic factors for neck pain in general practice
Jan L Hoving1, Henrica C W de Vet, Jos W R Twisk
1Institute for Research in Extramural Medicine, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands Unit of Occupational and Environmental Health, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands Institute for NIVEL, Utrecht, The Netherlands Department of General Practice, VU University Medical Center, Amsterdam, The Netherlands Institute of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands.
Identifying prognosis for neck pain is challenging. Older age and concurrent low back pain are key indicators of poorer neck pain outcomes in the long term.
Area of Science:
- Orthopedics
- General Practice
- Epidemiology
Background:
- Prognostic studies for neck pain are limited, especially with long-term follow-up.
- General practitioners (GPs) require easily measurable indicators for predicting neck pain outcomes.
Purpose of the Study:
- To identify short- and long-term prognostic indicators for neck pain.
- To assess the predictability of these indicators in a general practice setting.
Main Methods:
- Prospective cohort study involving 183 patients (18-70 years) with neck pain.
- Outcome measures included perceived recovery, pain intensity, and neck dysfunction at 7 and 52 weeks.
- Logistic and linear regression analyses were used to identify prognostic indicators.
Main Results:
- 63% of patients recovered after 1 year.
- Short-term poor outcomes were associated with older age (>=40), low back pain, and headache.
- Long-term poor outcomes were linked to older age, low back pain, previous trauma, longer pain duration, stable pain, and prior neck pain.
- Predictive models had weak explanatory power (R(2) 24-36%).
Conclusions:
- Older age and concomitant low back pain are consistent indicators of a less favorable neck pain prognosis.
- Current prognostic models offer limited predictive value for GPs managing sub-acute and chronic neck pain.