The associations between sedentary behavior and neck pain: a systematic review and meta-analysis

This study aimed to systematically evaluate the associations between sedentary behavior (SB) in daily life and the risk of neck pain (NP), and to investigate the dose-response relationships between these variables across different populations, including variations in age, sex, occupation, and lifestyle practices.

We conducted a systematic literature search of PubMed, Web of Science, Scopus, and Embase for cross-sectional, cohort and case-control studies examining the association between SB and NP risk. The National Institute of Health (NIH) quality assessment tool was utilized to evaluate study quality. Odds ratios (ORs) and relative risks (RRs) with 95% confidence intervals (CIs) were used to assess the association between SB and NP. Due to significant heterogeneity among the studies, a random-effects model was employed for the meta-analysis to obtain pooled estimates.

A total of 25 studies with 43,184 participants met the eligibility criteria. Overall, the meta-analysis revealed a significant relationship between SB and NP (OR = 1.46, 95%CI: 1.33, 1.60). Subgroup analyses revealed that the risk of NP was greater in female (OR = 1.43, 95%CI: 1.22, 1.67) than in male (OR = 1.13, 95%CI: 1.01, 1.27) and was greater in employees (OR = 1.97, 95%CI: 1.70, 2.28) than in students (OR = 1.26, 95%CI: 1.15, 1.39). Among screen-based SB, using mobile phones conferred the greatest risk of NP (OR = 1.82, 95%CI: 1.27, 2.61), followed by using computers (OR = 1.23, 95%CI: 1.08, 1.40), whereas watching TV was not a significant risk (OR = 1.20, 95%CI: 0.99, 1.44). Moreover, SB ≥ 4 h per day (h/d) increased the risk of NP (OR = 1.60, 95%CI: 1.38, 1.87), and the risk further increased with SB ≥ 6 h/d (OR = 1.88, 95%CI: 1.42, 2.48). The risk of NP increased with a screen-based SB dose ≥ 1 h/d (OR = 1.28, 95%CI: 1.17, 1.44), ≥ 2 h/d (OR = 1.35, 95%CI: 1.18, 1.55), and ≥ 4 h/d (OR = 1.45, 95%CI: 1.26, 1.67).

SB is a notable risk factor for NP, with the risk escalating with longer durations of sedentary time. Targeted preventative measures, particularly for high-risk groups like female and employees, are necessary. Public health initiatives should encourage the reduction of sedentary behaviors and the promotion of physical activity to enhance neck health and alleviate the global prevalence of NP.