Multidimensional Analysis of Physical, Psychosocial, and Cognitive Impairment in People with Chronic Neck Pain

Background and Objectives: Chronic neck pain is a prevalent condition linked to functional disability and maladaptive pain-related behaviors. Although the physical and psychosocial impairments have been extensively studied in the literature, the factors related to cognitive impairments are not fully understood. This study aimed to examine the physical, psychosocial, and cognitive impairments associated with chronic neck pain and examine the variables associated with cognitive performance in this population. Materials and Methods: This cross-sectional study included 87 individuals with chronic neck pain. Pain sensitivity, neck disability, physical capacity, cervical muscle strength, pain catastrophizing, kinesiophobia, and self-reported central sensitization were assessed in all participants. Within the scope of the neuropsychological assessment, global cognition, processing speed, attention, and executive functioning were evaluated. The relationship between physical, psychosocial, and cognitive impairments was assessed using Spearman correlation. Additionally, a multiple linear regression analysis was performed to assess the extent to which the independent variables were associated with cognitive performance. Results: Global cognition was moderately correlated with pain intensity (r = -0.427, p < 0.001) and pain catastrophizing (r = -0.414, p < 0.001). Difficulties in response inhibition were moderately related to age (r = 0.440, p < 0.001). Cervical muscle strength (r = 0.384-0.233) and physical capacity (r = 0.332) were also weakly correlated with global cognition (p < 0.05). Age exhibited the strongest relationship with global cognition (β = -0.332, p < 0.001), followed by pain intensity (β = -0.291, p = 0.004) and pain sensitivity (β = 0.253, p = 0.011), with an explained variance of 30.8%. Additionally, age showed the strongest association with difficulties in processing speed (β = 0.448, p < 0.001), followed by kinesiophobia (β = 0.325, p = 0.001) and neck disability (β = 0.262, p = 0.030), with an explained variance of 34.2%. Conclusions: These findings suggest that increased nociceptive sensitization and deficits in physical health may be associated with maladaptive pain-related coping strategies in individuals with chronic neck pain. Furthermore, cognitive impairments in these individuals may reflect a multidimensional association of demographic, physical, psychosocial, and sensorial mechanisms.