Sedentary behavior and neck pain in adults: A systematic review and meta-analysis

Sedentary lifestyle is an imperative risk for musculoskeletal pain. We sought to investigate the association between different types of sedentary behaviors (SBs) and neck pain (NP) among adults. A systematic search was conducted in PubMed, Web of Science, Embase, Scopus, and Google Scholar up to the end of April 2023. The odds ratio (95% CI) was considered as the desired effect size for the association between SBs and the NP. Among 1881 records found by primary search, 46, and 27 reports were included in the qualitative and quantitative analysis respectively. All included studies qualified as good or fair. Our results indicated that SB is a risk factor for NP among adults (OR = 1.5, [1.29, 1.76]). Computer and mobile phone use were also found to be considerable risk factors for NP (OR = 1.3, [1.12, 1.53], and OR = 2.11, [1.32, 3.42] respectively). However, sitting time showed an insignificant association with NP (OR = 1.33, [0.86, 2.07]). Subgroup analysis revealed that SBs are a significant risk factor for NP among university students (OR = 1.58, [1.27, 1.97]), but the association among office workers was marginally insignificant (OR = 1.36, [0.98, 1.89]). According to the meta-regression results, the male gender was found to increase the risk of NP. Meanwhile, Egger's test revealed the presence of publication bias (p-value <0.0001). A sedentary lifestyle as well as computer and mobile phone use is associated with a considerable risk of NP among adults, especially university students. Further, longitudinal studies are needed to better clarify the causality relationships.