The annual incidence and course of neck pain in the general population: A population-based cohort study

University of Toronto, Toronto, Ontario, Canada
Pain (Impact Factor: 5.21). 01/2005; 112(3):267-73. DOI: 10.1016/j.pain.2004.09.004
Source: PubMed

ABSTRACT Although neck pain is a common source of disability, little is known about its incidence and course. We conducted a population-based cohort study of 1100 randomly selected Saskatchewan adults to determine the annual incidence of neck pain and describe its course. Subjects were initially surveyed by mail in September 1995 and followed-up 6 and 12 months later. The age and gender standardized annual incidence of neck pain is 14.6% (95% confidence interval: 11.3, 17.9). Each year, 0.6% (95% confidence interval: 0.0-1.1) of the population develops disabling neck pain. The annual rate of resolution of neck pain is 36.6% (95% confidence interval: 32.7, 40.5) and another 32.7% (95% confidence interval: 25.5, 39.9) report improvement. Among subjects with prevalent neck pain at baseline, 37.3% (95% confidence interval: 33.4, 41.2) report persistent problems and 9.9% (95% confidence interval: 7.4, 12.5) experience an aggravation during follow-up. Finally, 22.8% (95% confidence interval: 16.4, 29.3) of those with prevalent neck pain at baseline report a recurrent episode. Women are more likely than men to develop neck pain (incidence rate ratio=1.67, 95% confidence interval 1.08-2.60); more likely to suffer from persistent neck problems (incidence rate ratio=1.19, 95% confidence interval 1.03-1.38) and less likely to experience resolution (incidence rate ratio=0.75, 95% confidence interval 0.63-0.88). Neck pain is a disabling condition with a course marked by periods of remission and exacerbation. Contrary to prior belief, most individuals with neck pain do not experience complete resolution of their symptoms and disability.

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Available from: Vicki Kristman, Sep 28, 2015
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    • "Cervical pain can cause great personal suffering, incapacity, a lower quality of life, and reduced productivity, as well as creating high socioeconomic costs for patients and society as a whole [1] [2] [3]. For most sufferers, its course involves remission and exacerbation rather than chronic or complete resolution [2]. However, one specific cause cannot be identified and thus the term nonspecific neck pain (NS-NP) has been commonly used as its classification [4]. "
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    ABSTRACT: . The aim of the present study was to assess the immediate effects of auricular acupuncture (AA) on the electromyographic (EMG) activity of the upper trapezius muscle and pain in nonspecific neck pain (NS-NP) patients. Twelve patients with NS-NP (NS-NP group) and 12 healthy subjects (HS Group) were enrolled in a randomized, single-blinded, crossover study. Each subject received a single session of AA and sham AA (SAA). Surface EMG activity was measured in the upper trapezius muscle at different “step contractions” of isometric shoulder elevation (15%, 20%, 25%, and 30% MVC). The outcome measure in patients with NS-NP was based on the numerical pain rating scale (NRS). AA treatment led to a significant decrease in EMG activity in both groups (NS-NP group: p = 0.0001; HS group: p < 0.0001—ANOVA test). This was not the case for the SAA treatment (NS-NP group: p = 0.71; HS group: p < 0.54). Significant decreases ( p < 0.001) in the NRS were found for both treatments (AA and SAA). This study demonstrated the immediate effect of auricular acupuncture on the electromyographic activity of the upper trapezius muscle but the effect of this intervention on pain symptoms in patients with nonspecific neck pain was inconclusive.
    Journal of Evidence-Based Complementary and Alternative Medicine 09/2015; 2015(3). DOI:10.1155/2015/523851
    • "The 12-month prevalence of neck pain in adults varies from 30% to 50% [3]. Neck pain is commonly associated with activity limitations and disability [3] [4] [5] [6]. The prevalence of neck pain peaks in middle-aged groups during the most productive years of a person's life. "
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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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    • "Chronic cervical spine pain is particularly challenging to treat, and data regarding the long-term efficacy of traditional therapies has been extremely discouraging [1]. The prevalence of neck pain in the general population has been reported to range between 30% and 50%, with women over 50 making up the larger portion [1] [2] [3]. Although many of these cases resolve with time and require minimal intervention, the recurrence rate of neck pain is high, and *Address correspondence to either of these authors at the Address correspondence to either of these authors at the Caring Medical and Rehabilitation Services, S.C., 715 Lake St., Ste. "
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    ABSTRACT: The use of conventional modalities for chronic neck pain remains debatable, primarily because most treatments have had limited success. We conducted a review of the literature published up to December 2013 on the diagnostic and treatment modalities of disorders related to chronic neck pain and concluded that, despite providing temporary relief of symptoms, these treatments do not address the specific problems of healing and are not likely to offer long-term cures. The objectives of this narrative review are to provide an overview of chronic neck pain as it relates to cervical instability, to describe the anatomical features of the cervical spine and the impact of capsular ligament laxity, to discuss the disorders causing chronic neck pain and their current treatments, and lastly, to present prolotherapy as a viable treatment option that heals injured ligaments, restores stability to the spine, and resolves chronic neck pain. The capsular ligaments are the main stabilizing structures of the facet joints in the cervical spine and have been implicated as a major source of chronic neck pain. Chronic neck pain often reflects a state of instability in the cervical spine and is a symptom common to a number of conditions described herein, including disc herniation, cervical spondylosis, whiplash injury and whiplash associated disorder, postconcussion syndrome, vertebrobasilar insufficiency, and Barré-Liéou syndrome. When the capsular ligaments are injured, they become elongated and exhibit laxity, which causes excessive movement of the cervical vertebrae. In the upper cervical spine (C0-C2), this can cause a number of other symptoms including, but not limited to, nerve irritation and vertebrobasilar insufficiency with associated vertigo, tinnitus, dizziness, facial pain, arm pain, and migraine headaches. In the lower cervical spine (C3-C7), this can cause muscle spasms, crepitation, and/or paresthesia in addition to chronic neck pain. In either case, the presence of excessive motion between two adjacent cervical vertebrae and these associated symptoms is described as cervical instability. Therefore, we propose that in many cases of chronic neck pain, the cause may be underlying joint instability due to capsular ligament laxity. Currently, curative treatment options for this type of cervical instability are inconclusive and inadequate. Based on clinical studies and experience with patients who have visited our chronic pain clinic with complaints of chronic neck pain, we contend that prolotherapy offers a potentially curative treatment option for chronic neck pain related to capsular ligament laxity and underlying cervical instability.
    The Open Orthopaedics Journal 10/2014; 8(1):326-45. DOI:10.2174/1874325001408010326
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