Detailed, evidence-based help for common painful problems

Being female and other ways to get neck pain

 •  • by Paul Ingraham
Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

I spent the entire day yesterday reading the spotty scientific literature on risk factors for neck pain. It’s bizarrely inadequate for the usual reasons: because the right kinds of studies are slow and expensive. So there’s a lot we still don’t know about important potential risk factors, especially the psychological ones. But we do know this (mostly from McLean 2010 and Paksaichol 2012):

If you’re a woman smoker “of a certain age” with a history of neck & back pain in a tough job with a crappy boss, you are totally screwed. Neck pain city!

Being a woman is an especially clear risk factor for neck pain, and no one has a clue why. (And now every woman reading this is now thinking, “Fantastic: as if being a woman in this world wasn’t challenging enough, now this?” I wish it wasn’t true, but it is literally one of the only things we know for sure.)

Also, if you often “feel tense,” your risk of developing neck pain is more than 4 times higher than someone who never feels tense — the conclusion of Huysmans 2012 one of the most intriguing studies I stumbled on.

Another interesting one: Paksaichol et al found computer display position (too high, too low) is definitely not actually a risk factor for neck pain, a classic example of failed common sense. So I’ve been wrong about that for 20 years.

I’ve updated my neck pain book with a much more detailed discussion.

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