Physical and Psychological Predictors for Persistent and Recurrent Non-Specific Neck Pain: A Systematic Review

Area of Science:

• Pain research
• Prognosis studies
• Clinical psychology

Background:

• Non-specific neck pain frequently becomes persistent or recurrent, leading to disability.
• Identifying predictive factors is crucial for managing chronic neck pain.
• This review focuses on physical and psychological predictors of neck pain persistence and disability.

Purpose of the Study:

• To systematically review physical and psychological factors predicting persistent and recurrent neck pain and disability.
• To assess the certainty of evidence for these predictive factors.

Main Methods:

• Systematic review of six prospective cohort studies.
• Searched five databases up to January 31, 2025.
• Assessed risk of bias using QUIPS and certainty of evidence using GRADE.

Main Results:

• High pain catastrophizing and psychological distress consistently predict persistent neck pain, disability, and incidence (low to moderate certainty).
• Limited or inconsistent evidence exists for physical factors like neck flexion strength, pain thresholds, and endurance.
• No significant association was found between cervical range of motion, neck extensor strength, and disability (low certainty).

Conclusions:

• Pain catastrophizing and psychological distress are key predictors of persistent neck pain.
• Early assessment of these psychological factors can identify at-risk patients.
• Psychological interventions targeting maladaptive beliefs may reduce neck pain and disability.