Predictive Factors of Initial Pain and Disability in Patients Presenting With Neck Pain for Rehabilitation

Background Neck pain is a complex and multifactorial condition with increasing global prevalence and a substantial impact on disability. Understanding the interplay between physical and psychological factors at the onset of rehabilitation is critical for effective, individualized care. Objective To identify physical (body weight/height, pain chronicity, physical activity, posture) and psychological (anxiety, depression, job satisfaction) predictors of pain intensity and disability in patients with neck pain presenting for physiotherapy, aiming to enhance early-stage assessment and address a research gap regarding predictors at the point of initial physiotherapy evaluation. Methods A cross-sectional cohort study was conducted involving 71 patients with neck pain attending a physiotherapy clinic. Clinical assessments and validated questionnaires were used to evaluate physical and psychological parameters, including the Neck Disability Index (NDI), Numeric Rating Scale for pain (NRS), Hospital Anxiety and Depression Scale (HADS), International Physical Activity Questionnaire (IPAQ), and the Minnesota Satisfaction Questionnaire - Short Form (MSQ-Short). Stepwise multiple regression analyses were performed to identify predictors of pain intensity and disability. Results Pain intensity was positively associated with disability (r = 0.41, p < 0.001) and depression (r = 0.27, p < 0.001), but negatively associated with anxiety (r = -0.18, p = 0.012). Disability showed strong associations with pain intensity (r = 0.41, p < 0.001), depression (r = 0.54, p < 0.001), and anxiety (r = 0.34, p < 0.001). In the multivariable analysis, lower anxiety levels significantly predicted higher pain intensity (β = -0.134, p < 0.001), an unexpected finding that may reflect coping-related mechanisms. Higher disability was predicted by greater depression (β = 0.257, p < 0.001) and lower job satisfaction (β = -0.215, p < 0.001). The models explained 37.7% of the variance in pain intensity and 49.3% in disability. Conclusion Both physical and psychological factors significantly influence pain and disability in patients with neck pain at the initial physiotherapy evaluation. Early identification of these predictors may improve clinical decision-making and rehabilitation outcomes. Future longitudinal studies in broader populations are recommended to validate these findings.