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Only a history of neck pain and being a woman are likely risk factors for neck pain

PainSci » bibliography » Paksaichol et al 2012
updated
Tags: etiology, neck, garbage in, garbage out, pro, head/neck, spine, research

Four pages on PainSci cite Paksaichol 2012: 1. The Complete Guide to Chronic Tension Headaches2. The Complete Guide to Neck Pain & Cricks3. Being female and other ways to get neck pain4. Poor posture versus postural stress

PainSci commentary on Paksaichol 2012: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

As of 2017, I think this 2012 review is still the best available about neck pain risk factors, but the conclusions are weak due to a lack of good quality data to review.

The purpose of this review was to focus on the only kind of science (“prospective cohort studies”) that can properly determine factors that cause neck pain. Most research on this topic so far has

only allowed for the association between exposures and outcome to be examined. It is therefore not possible to establish the causal relationship between exposures and outcome. Research to identify the risk factors of neck pain requires longitudinal research design, which permits the tracking of study participants over time.

They found only five suitable high quality studies, and a couple of lower quality ones, all of them so different that no statistical analysis was possible. Basically, the authors were limited to giving us their subjective impressions of these five studies. With regards to psychological factors — as well as some other usual suspects — they didn't really see much.

Interestingly, for a large number of factors that have been mentioned in the literature as risk factors for neck pain, such as high physical leisure activity, low social support, and high psychosocial stress, we found no predictive value for future neck pain in office workers.

This isn’t evidence of absence: there just wasn’t enough of the right kind of data on the topic. “Most variables have been investigated by only one study.” They did find “strong evidence for … not having predictive value” of high keyboard usage time and poor perception of computer placement. Interesting.

This paper is quite similar to McLean et al, but with higher standards and two years fresher. McLean et al. judged several more risk factors to be supported by “strong” evidence: “older age, female gender, high job demands, low social or work support, being an ex-smoker, a history of low back disorders and a history of neck disorders.” They also specifically called out the lack of evidence regarding “many clinical, physical, psychological and socio-demographic variables.”

It’s also similar to Jun et al, which is five years fresher but also not as rigorous.

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

The purpose of this study was to systematically review prospective cohort studies to gain insights into risk factors for the development of non-specific neck pain in office workers as well as to assess the strength of evidence. Publications were systematically searched from 1980 - March 2011 in several databases. The following key words were used: neck pain paired with risk or prognostic factors and office or computer or visual display unit or visual display terminal. Relevant studies were retrieved and assessed for methodological quality by two independent reviewers. The strength of the evidence was based on methodological quality and consistency of the results. Five high-quality and two low-quality prospective cohort studies investigating the predictive value of 47 individual, work-related physical and work-related psychosocial factors for the onset of non-specific neck pain in office workers were included in this review. Strong evidence was found for female gender and previous history of neck complaints to be predictors of the onset of neck pain. Interestingly, for a large number of factors that have been mentioned in the literature as risk factors for neck pain, such as high physical leisure activity, low social support, and high psychosocial stress, we found no predictive value for future neck pain in office workers. Literature with respect to the development of non-specific neck pain in office workers is scant. Only female gender and previous history of neck complaints have been identified as risk factors that predict the onset of neck pain.

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