Change in Attitude and Beliefs About Neck Pain Needed

Neck pain that doesn't go away can be very disabling. Understanding causes, risk factors, natural course, and prognosis of chronic neck pain can help direct treatment.

The World Health Organization's (WHO) Task Force on Neck Pain has spent the last five years screening 31,000 journal titles and reviewing 1,200 articles to bring us the most up-to-date opinions on the prevention, diagnosis, and treatment of neck pain.

In this executive summary, the authors provide us with a bulleted list of key findings from the Task Force. They review the results of new research and present a new model for classifying neck pain.

There are many factors that impact patients with neck pain. Some may be preventable, others can be modified (changed), and the rest are unmodifiable (can't be changed). Treatment to reduce pain and disability and return workers to the job place has varying results.

Analyzing all these factors may help us find better ways to prevent and treat neck pain. For example, age, gender, and genetics as contributing factors can't be changed. But exposure to tobacco products and level of physical activity and exercise can be modified. And making positive changes in either of these categories has been shown to make a difference.

Workplace stresses, repetitive motions, and sitting for long periods at a desk or in front of a computer also contribute to neck pain. But changes in these risk factors don't seem to reduce neck pain in workers. On the other hand, lack of insurance for neck pain and suffering from whiplash injury is linked with faster recovery and improved outcomes.

It's safe to say that most patients with neck pain don't ever get 100 per cent better. Up to 85 per cent still have neck pain five years later. Older age, poor health, and a previous history of neck pain are negative risk factors for prognosis. This means patients with these risk factors aren't as likely to get better compared with younger patients in good health with no previous history of neck pain.

If would be helpful if workplaces, insurance companies, and patients understood the likelihood of chronic pain from neck injuries. Changes in expected recovery rates and outcomes are needed along with more effective treatment for these conditions.

Classifying neck pain by severity of symptoms and function may help us in choosing treatments that are effective and measurable. Patient’s personal preferences should always be considered when choosing treatment options with potential adverse side effects.

The ultimate goal is to prevent neck pain. When it does occur, then reducing disability is the next step.



References: Scott Haldeman, DC, MD, PhD, et al. The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. In Spine. Supplement to February 15, 2008. Vol. 33. No. 45. Pp. S5-S7.