P99. The Association Between Prevalent Neck Pain and Health-related Quality of Life: A Cross-sectional Analysis

Department of Public Health Sciences, University of Toronto, Toronto, Canada.
European Spine Journal (Impact Factor: 2.07). 12/2008; 18(3):371-81. DOI: 10.1007/s00586-008-0823-6
Source: PubMed


The aim of this study was to examine the association between grades of neck pain severity and health-related quality of life (HRQoL), using a population-based, cross-sectional mailed survey. The literature suggests that physical and mental HRQoL is worse for individuals with neck pain compared to those without neck pain. However, the strength of the association varies across studies. Discrepancies in study results may be attributed to the use of different definitions and measures of neck pain and differences in the selection of covariates used as control variables in the analyses. The Saskatchewan Health and Back Pain Survey was mailed to 2,184 randomly selected Saskatchewan adults of whom 1,131 returned the questionnaire. Neck pain was measured with the Chronic Pain Questionnaire and categorized into four increasing grades of severity. We measured HRQoL with the SF-36 Health Survey and computed the physical and mental component summary scores. We built separate multiple linear regression models to examine the association between grades of neck pain and physical and mental summary scores while controlling for sociodemographic, general health and comorbidity covariates. Our crude analysis suggests that a gradient exists between the severity of neck pain and HRQoL. Compared to individuals without neck pain, those with Grades III-IV neck pain have significantly lower physical (mean difference = -13.9/100; 95% CI = -16.4, -11.3) and mental (mean difference = -10.8/100; 95% CI = -13.6, -8.1) HRQoL. Controlling for covariates greatly reduced the strength of association between neck pain and physical HRQoL and accounted for the observed association between neck pain and mental HRQoL. In the comorbidity model, the strength of association between Grades III-IV neck pain and PCS decreased by more than 50% (mean difference = -4.5/100; 95% CI = -6.9, -2.0). In the final PCS model, Grades III-IV neck pain coefficients changed only slightly from the comorbidity model (mean difference = -4.4/100; 95% CI = -6.9, -1.9). This suggests that comorbid conditions account for most of the association between neck pain and PCS score. It was concluded that prevalent neck pain is weakly associated with physical HRQoL, and that it is not associated with mental HRQoL. Our cross-sectional analysis suggests that most of the observed association between prevalent neck pain and HRQoL is attributable to comorbidities.


Available from: Linda Carroll
    • "Health-related quality of life incorporates physical, mental, and social well-being rather than just defining health as the absence of disease [7]. Findings from a cross-sectional analysis of the Saskatchewan Health and Back Pain Survey suggest that neck pain was weakly associated with worse physical HRQoL and not associated with mental HRQoL [8]. However, it remains unclear whether neck pain is a risk factor or an outcome of poor HRQoL. "
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    ABSTRACT: Summary of Background Data Current evidence suggests that neck pain is negatively associated with health related quality of life (HRQoL). However, these studies are cross-sectional and do not inform the association between neck pain and future HRQoL. Purpose The purpose of this study was to investigate the association between increasing grades of neck pain severity and health related quality of life (HRQoL) six months later. In addition this longitudinal study examines the crude association between the course of neck pain and HRQoL. Study Design Population-based cohort study. Patient Sample Eleven hundred randomly sampled Saskatchewan adults. Outcome measures The mental and physical component summary of the SF-36 questionnaire. Methods We formed a cohort of 1100 randomly sampled Saskatchewan adults in September 1995. We used the Chronic Pain Questionnaire to measure neck pain and its related disability. The SF-36 questionnaire was used to measure physical and mental HRQoL six months later. Multivariable linear regression was used to measure the association between graded neck pain and HRQoL while controlling for confounding. Anova and t-tests were used to measure the crude association between four possible courses of neck pain and HRQoL at six months. The neck pain trajectories over six months were no or mild neck pain, improving neck pain, worsening neck pain and persistent neck pain. Finally ANOVA was used to examine changes in baseline to six-month PCS and MCS scores between the four neck pain trajectory groups. Results The six month follow-up rate was 74.9%. We found an exposure-response relationship between neck pain and physical HRQoL after adjusting for age, education, arthritis, low back pain and depressive symptomatology. Compared to participants without neck pain at baseline, those with mild (β = -1.53; 95% CI: -2.83, -0.24), intense (β = -3.60, 95% CI: -5.76, -1.44), or disabling (β = -8.55; 95% CI: -11.68, -5.42) neck pain had worse physical HRQoL six months later. We did not find an association between neck pain and mental HRQoL. A worsening course of neck pain and persistent neck pain were associated with worse physical HRQoL. Conclusions We found that neck pain was negatively associated with physical, but not mental HRQoL. Our analysis suggests that neck pain may be a contributor of future poor physical HRQoL in the population. Raising awareness of the possible future impact of neck pain on physical HRQoL is important for health care providers and policy makers with respect to the management of neck pain in populations.
    The Spine Journal 12/2014; 15(4). DOI:10.1016/j.spinee.2014.12.009 · 2.43 Impact Factor
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    • "In other studies examining the association between neck pain and health related quality of life (HRQoL), worse physical and mental HRQoL among subjects with neck pain has also been reported, implying significant health impact (19, 20). On the other hand, another recent study showed that most of the observed association between neck pain and HRQoL is attributable to comorbidities (21). While the differential influence of neck pain on QOL according to gender has not been reported previously, QoL as measured with SF-36 was reported to be significantly worse in females in other musculoskeletal problems such as low back pain and symptomatic peripheral osteoarthritis (22). "
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    ABSTRACT: Neck pain is a common musculoskeletal condition, which causes substantial medical cost. In Korea, prevalence of neck pain in community based population, especially in elderly subjects, has scarcely been reported. We evaluated the prevalence, the severity and the risk factors of neck pain in elderly Korean community residents. Data for neck pain were collected for 1,655 subjects from a rural farming community. The point, 6-months and cumulative lifetime prevalence of neck pain was obtained in addition to the measurement of the severity of neck pain. The mean age of the study subjects was 61 yr and 57% were females. The lifetime prevalence of neck pain was 20.8% with women having a higher prevalence. The prevalence did not increase with age, and the majority of individuals had low-intensity/low-disability pain. Subjects with neck pain had a significantly worse SF-12 score in all domains except for mental health. The prevalence of neck pain was significantly associated with female gender, obesity and smoking. This is the first large-scale Korean study estimating the prevalence of neck pain in elderly population. Although the majority of individuals had low-intensity/low-disability pain, subjects with neck pain had a significantly worse SF-12 score indicating that neck pain has significant health impact.
    Journal of Korean medical science 05/2013; 28(5):680-6. DOI:10.3346/jkms.2013.28.5.680 · 1.27 Impact Factor
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    • "Pain is a priority for patients seeking care [18] and thus it is perhaps not surprising that pain largely mediated the association between doctor diagnosed OA and QoL. Further, pain assessed at one site in cross sectional studies is known to be associated with poorer QoL, [19,20] but no studies that have looked at pain at many sites. Our data suggests that pain at all sites measured independently contribute to QoL, there is a dose response association between number of pain sites and QoL, and severity of pain is also related to QoL. "
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    ABSTRACT: Background Pain and radiographic changes are common in persons with osteoarthritis, but their relative contributions to quality of life are unknown. Methods Prospective cohort study of 1098 men and women aged 50–80 years, randomly selected from the electoral roll. Participants were interviewed at baseline and approximately 2.6 and five years later. Participants self-reported prior diagnosis of arthritis and presence of joint pain. Joint space narrowing (JSN) and osteophytes at the hip and knee were assessed by X-ray. Quality of life (QoL) was assessed using the Assessment of QoL (AQoL) instrument. Data was analysed using linear regression and mixed modelling. Results The median AQoL score at baseline was 7.0, indicating very good QoL. Prevalence of pain ranged from 38-62%. Over five years of observation, pain in the neck, shoulders, back, hips, hands, knees and feet were all independently and negatively associated with QoL, in a dose–response relationship. Diagnosed osteoarthritis at all sites was associated with poorer QoL but after adjustment for pain, this only remained significant at the back. Radiographic OA was not associated with QoL. While AQoL scores declined over five years, there was no evidence of an interaction between pain and time. Conclusions Pain is common in older adults, is stable over time, and the strongest musculoskeletal correlate of QoL. It also mediates the association between diagnosed OA and QoL. Since the same factors were associated with quality of life over time as at baseline, this suggests that quality of life tracks over a five year period.
    BMC Musculoskeletal Disorders 09/2012; 13(1):168. DOI:10.1186/1471-2474-13-168 · 1.72 Impact Factor
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