People with neck pain do not experience a complete resolution of condition.
Much like an episode of lower back pain consumers who have a bout of neck pain don’t simply all resolve with time and simple rest. Neck pain is common with typical 12 month prevalence estimates of 30%-50% in adults and within children and adolescents 21%-42%. Neck pain in the general population is frequently persistent and recurrent with research suggesting that between 50% and 85% will have symptoms again in 1-5 years. This is the first systematic review of the prognosis of idiopathic neck pain and validates that the prognosis of acute idiopathic neck pain is markedly worse than previously recognized and resolution is incomplete.
Prognosis of Acute Idiopathic Neck Pain is Poor: A Systematic Review and Meta-Analysis
Presented to the International Association for the Study of Pain World Pain Congress, September 2, 2010, Montreal, QC, Canada.
Hush JM, PhD, et al. Prognosis of Acute Idiopathic Neck Pain is Poor: A systematic review and
meta-analysis. Arch Phys Med Rehabil 92:824-9, 2011
Objective
To conduct a systematic review and meta-analysis on the prognosis of acute idiopathic neck pain and disability.
Data Sources
EMBASE, CINAHL, Medline, AMED, PEDro, and CENTRAL were searched from inception to July 2009, limited to human studies. Reference lists of relevant systematic reviews were searched by hand. Search terms included: neck pain, prognosis, inception, cohort, longitudinal, observational, or prospective study and randomized controlled trial.
Study Selection
Eligible studies were longitudinal cohort studies and randomized controlled trials with a no treatment or minimal treatment arm that recruited an inception cohort of acute idiopathic neck pain and reported pain or disability outcomes. Eligibility was determined by 2 authors independently. Seven of 20,085 references were included.
Data Extraction
Pain and disability data were extracted independently by 2 authors. Risk of bias was assessed independently by 2 authors.
Data Synthesis
Statistical pooling showed a weighted mean pain score (0–100) of 64 (95% confidence interval [CI], 61–67) at onset and 35 (95% CI, 32–38) at 6.5 weeks. At 12 months, neck pain severity remained high at 42 (95% CI, 39–45). Disability reduced from a pooled weighted mean score (0–100) at onset of 30 (95% CI, 28–32) to 17 (95% CI, 15–19) by 6.5 weeks, without further improvement at 12 months. Studies varied in length of follow-up, design, and sample size.
Conclusions
This review provides Level I evidence that the prognosis of acute idiopathic neck pain is worse than currently recognized. This evidence can guide primary care clinicians when providing prognostic information to patients. Further research to identify prognostic factors and long-term outcomes from inception cohorts would be valuable.