The annual incidence and course of neck pain in the general population: a population-based cohort study Prevalence and occupational associations of neck pain in the British population. Risk factors for neck pain: a longitudinal study in the general population Risk factors for neck pain in office workers: a prospective study Neck Pain in the General Population High Quantitative Job Demands and Low Coworker Support As Risk Factors for Neck Pain: Results of a Prospective Cohort Study The prevalence of neck pain The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Neck Pain in Hong Kong: A Telephone Survey on Prevalence, Consequences, and Risk Groups Manual Therapy, Physical Therapy, or Continued Care by a General Practitioner for Patients with Neck Pain Individual, physical and psychological risk factors for neck pain in Australian office workers: a 1-year longitudinal study The Saskatchewan Health and Back Pain Survey: The Prevalence of Neck Pain and Related Disability in Saskatchewan Adults Predicting Persistent Neck Pain: A 1-Year Follow-up of a Population Cohort Risk factors in the onset of neck/shoulder pain in a prospective study of workers in industrial and service companies Predictive Factors for Neck and Shoulder Pain: A Longitudinal Study in Young Adults High physical and psychosocial load at work and sickness absence due to neck pain. Validity of five common manual neck pain provoking tests.
& NA ; 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 r and omly 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 st and ardized 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 OBJECTIVES This study determined the prevalence of neck pain and its relation to occupation and occupational activities in the general population . METHODS A question naire was mailed to 21 201 subjects aged 16 - 64 years , r and omly selected from the patient registers of general practice s in Engl and , Scotl and , and Wales , and to 993 subjects r and omly selected from pay records of the armed services . Information was collected on occupation , workplace physical activities , neck pain in the past week and year , headaches , and feelings of tiredness or stress . Associations were explored by logistic regression , the result ant odds ratios being converted to prevalence ratios ( PR ) . RESULTS Among 12907 respondents , 4348 and 2528 reported neck pain  in past year ( 1421 with pain interfering with normal activities ) and week , respectively . Symptoms were the most prevalent among male construction workers [ past week and year 24 % and 38 % ( pain interfering with activities 11 % ) , respectively ] , followed by nurses , armed services members , and the unemployed . Generally the age-st and ardized prevalence of neck pain varied little by occupation . Work with arms above the shoulders for > 1 hours/day was associated with a significant excess of symptoms [ PR 1.3 - 1.7 ( women ) and 1.2 - 1.4 ( men ) ] , but no associations existed for typing , lifting , vibratory tool use , or professional driving . Stronger neck-pain associations were found with frequent headaches ( PR 2.3 - 2.8 ) and frequent tiredness or stress ( PR 2.2 - 2.5 ) than with occupational activities . CONCLUSIONS The data provide evidence against a strong association between neck pain and the examined occupational physical activities . They suggest that psychosocial factors may be more important & NA ; The objective of the study was to examine the 1‐year cumulative incidence of episodic neck pain and to explore its associations with individual risk factors , including a history of previous neck injury . A baseline cross‐sectional survey of an adult general population sample made up of all 7669 adults aged 18–75 years , registered with two family practice s in South Manchester , United Kingdom , identified the study population of adults with no current neck pain . This study population was surveyed again 12 months later to identify all those who had experienced neck pain during the follow‐up period . At follow‐up , cumulative 1‐year episode incidence of neck pain was estimated at 17.9 % ( 95 % confidence interval 16.0–19.7 % ) . Incidence was independent of age , but was more common in women . A history of previous neck injury at baseline was a significant risk factor for subsequent neck pain in the follow‐up year ( risk ratio 1.7 , 95 % confidence interval 1.2–2.5 ) , independent of gender and psychological status . Other independent baseline risk factors for subsequent neck pain included number of children , poor self‐assessed health , poor psychological status and a past history of low back pain . We have carried out a prospect i ve study in a general population sample and demonstrated that established risk factors for chronic pain predict future episodes of neck pain , and shown that in addition a history of neck injury is an independent and distinct risk factor . This finding may have major public health and medicolegal implication Background Persisting neck pain is common in society . It has been reported that the prevalence of neck pain in office workers is much higher than in the general population . The costs to the worker , employer and society associated with work-related neck pain are known to be considerable and are escalating . The factors that place office workers at greater risk of developing neck pain are not understood . The aim of this study is to investigate the incidence and risk factors of work-related neck pain in Australian office workers . Methods / design We will conduct a prospect i ve cohort study . A cohort of office workers without neck pain will be followed over a 12 month period , after baseline measurement of potential risk factors . The categories of risk factors being evaluated are physical ( cervical spine posture , range of movement , muscle endurance and exercise frequency ) , demographic ( age , sex ) , work environment ( sitting duration , frequency of breaks ) and psychosocial ( psychological distress and psychosocial work factors ) . Cox regression analysis will be used to identify risk factors associated with work-related neck pain , and will be expressed as hazard ratios with 95 % confidence intervals . The data will also enable the incidence of neck pain in this population to be estimated . Discussion In addition to clarifying the magnitude of this occupational health problem these data could inform policy in workplaces and provide the basis for primary prevention of neck pain in office workers , targeting the identified risk factors Study Design A r and omized cross-sectional question naire was used to determine the prevalence of neck pain in Norwegian adults . Objectives The frequency and duration of neck pain were assessed . Summary of Background Data Reliable epidemiologic studies on the prevalence of neck pain in the general population have been sparse . Methods A question naire that inquired about neck pain within the last year was sent to a r and om sample of 10,000 adult Norwegians . Results Overall , 34.4 % of the responders had experienced neck pain within the last year . A total of 13.8 % reported neck pain that lasted for more than 6 months . Conclusions Chronic neck pain is a frequent symptom in the general population , particularly in women . Although reservations have to be taken as to the interpretation , the reported prevalence of persisting pain after whiplash injuries is of the same magnitude as the prevalence of chronic neck pain in the general population Study Design . A 3-year prospect i ve cohort study among 1334 workers was conducted . Objective . To determine whether the work-related psychosocial factors of quantitative job dem and s , conflicting job dem and s , skill discretion , decision authority , supervisor support , coworker support , and job security are risk factors for neck pain . Summary of Background Data . Among the various risk factors for neck pain , work-related psychosocial factors play a major role . Previous studies on risk factors for neck pain often had a cross-sectional design , and did not take both physical and psychosocial factors into account . Methods . At baseline , data on work-related psychosocial factors were collected by means of a question naire . During the 3-year follow-up period , data on the occurrence of neck pain were collected by means of postal question naires . Individuals without neck pain at baseline were selected for the analyses . Cox regression analysis was applied to examine the relation between the work-related psychosocial factors and the cumulative incidence of neck pain . Adjustments were made for various physical factors and individual characteristics . Results . The analysis included 977 patients . Altogether , 141 workers ( 14.4 % ) reported that they had experienced neck pain at least once during the 3-year follow-up period . The relation of neck pain to high quantitative job dem and s ( relative risk [ RR ] , 2.14 ; 95 % confidence interval [ CI ] , 1.28–3.58 ) and low coworker support ( RR , 2.43 ; 95 % CI , 1.11–5.29 ) was statistically significant . An increased risk was found for low decision authority in relation to neck pain ( RR , 1.60 ; 95 % CI , 0.74–3.45 ) , but this relation was not statistically significant . Conclusions . High quantitative job dem and s and low coworker support are independent risk factors for neck pain . There are indications that another risk factor for neck pain is low decision authority The two northernmost counties in Sweden form together 1 of the 39 collaborating centers in the World Health Organization ( WHO ) MONICA ( MONItoring of trends and determinants in CArdiovascular disease ) project . At the last survey in 1999 , we added some questions about cervical spine complaints . Persons r and omly selected from the population in a geographically well-defined area completed a self-administered question naire . The sample included 8,356 subjects and 6,000 ( 72 % ) of them answered . 43 % of the population reported  neck pain  , more women ( 48 % ) than men ( 38 % ) . Women of working age had more neck pain than older ones , a phenomenon not seen among men . Chronic neck pain , defined as continuous pain of more than 6 months ' duration , was commoner in women ( 22 % ) than men ( 16 % ) . More than one fourth of the cases with chronic symptoms had a history of neck or head trauma and one third of these had sustained a whiplash type of injury . Thus , all types of neck trauma seem to be associated with chronic neck pain STUDY DESIGN Systematic review and best evidence synthesis . OBJECTIVES To describe the prevalence and incidence of  neck pain and disability in workers ; to identify risk factors for neck pain in workers ; to propose an etiological diagram ; and to make recommendations for future research . SUMMARY OF BACKGROUND DATA Previous review s of the etiology of neck pain in workers relied on cross-sectional evidence . Recently published cohorts and r and omized trials warrant a re- analysis of this body of research . METHODS We systematic ally search ed Medline for literature published from 1980 - 2006 . Retrieved articles were review ed for relevance . Relevant articles were critically appraised . Articles judged to have adequate internal validity were included in our best evidence synthesis . RESULTS One hundred and nine papers on the burden and determinants of neck pain in workers were scientifically admissible . The annual prevalence of neck pain varied from 27.1 % in Norway to 47.8 % in Québec , Canada . Each year , between 11 % and 14.1 % of workers were limited in their activities because of neck pain . Risk factors associated with neck pain in workers include age , previous musculoskeletal pain , high quantitative job dem and s , low social support at work , job insecurity , low physical capacity , poor computer workstation design and work posture , sedentary work position , repetitive work and precision work . We found preliminary evidence that gender , occupation , headaches , emotional problems , smoking , poor job satisfaction , awkward work postures , poor physical work environment , and workers ' ethnicity may be associated with neck pain . There is evidence that interventions aim ed at modifying workstations and worker posture are not effective in reducing the incidence of neck pain in workers . CONCLUSION Neck disorders are a significant source of pain and activity limitations in workers . Most neck pain results from complex relationships between individual and workplace risk factors . No prevention strategies have been shown to reduce the incidence of neck pain in workers Study Design . A cross-sectional telephone survey was conducted using a two-stage r and omization process . Objectives . The objectives of this paper were to investigate the prevalence of neck pain and their consequences and risk groups in the Hong Kong population . Summary of Background Data . There has been a lack of recent information on the prevalence and consequences of neck pain in the population of Hong Kong . Methods . A total of 664 subjects were interviewed on the socio-demographic characteristics , occurrence , and consequences of neck pain . A r and om sample of the respondents was reinterviewed after 7 to 10 days later , by another interviewer for the reliability check . Results . The lifetime prevalence of neck pain was 65.4 % ( 95 % confidence interval , 61.8%–69.0 % ) . The 12-month prevalence was 53.6 % ( 41.0 % in male , 59.0 % in female ) ( 95 % confidence interval , 49.8%–57.4 % ) . About 15.0 % of these patients had moderate to severe pain . Moreover , 4.5 % of these subjects had to limit their social activities and 3.1 % had to limit their work . Multiple logistic regression analysis showed that females , managers , administrators , and professionals have a high risk  of neck pain in the population of Hong Kong . Conclusion .  Neck pain  is highly prevalent in Hong Kong , particularly among females , managers , administrators , and professionals Context  Neck pain is common among primary care patients . Evidence on the effectiveness of therapies for neck pain is limited . A previous r and omized , controlled trial suggested benefits from manual therapy and physical therapy . Contribution This r and omized , controlled trial of manual therapy , physical therapy , and continued care by a doctor confirms the superiority of manual therapy and physical therapy over continued care . At 7 weeks , 68.3 % of patients in the manual therapy group reported resolved or much improved pain , compared with 50.8 % of patients in the physical therapy group and 35.9 % of patients in the continued care group . Clinical Implication s Primary care physicians should consider manual therapy when treating patients with neck pain .  The Editors Neck pain is a common problem in the general population , with point prevalences between 10 % and 15 % ( 1 - 3 ) . It is most common at approximately 50 years of age and is more common in women than in men ( 1 , 2 , 4 - 6 ) . Neck pain can be severely disabling and costly , and little is known about its clinical course ( 7 - 9 ) . Limited range of motion and a subjective feeling of stiffness may accompany neck pain , which is often precipitated or aggravated by neck movements or sustained neck postures . Headache , brachialgia , dizziness , and other signs and symptoms may also be present in combination with neck pain ( 10 , 11 ) . Although history taking and diagnostic examination can suggest a potential cause , in most cases the pathologic basis for neck pain is unclear and the pain is labeled nonspecific . Conservative treatment methods that are frequently used in general practice include analgesics , rest , or referral to a physical therapist or manual therapist ( 12 , 13 ) . Physical therapy may include passive treatment , such as massage , interferential current , or heat applications , and active treatment , such as exercise therapies . Physical therapists can specialize in passive manual ( or h and s-on ) techniques , including mobilization or manipulation ( high-velocity thrust techniques ) , also referred to as manual therapy ( 14 - 19 ) . According to the International Federation of Orthopedic Manipulative Therapies , Orthopedic manipulative ( manual ) therapy is a specialization within physical therapy and provides comprehensive conservative management for pain and other symptoms of neuro-musculo-articular dysfunction in the spine and extremities ( unpublished data ) . Today , many different manual therapy approaches are applied by various health professionals , including medical doctors , physical therapists , massage therapists , manual therapists , chiropractors , and osteopathic doctors . Review s of trials involving manual therapy or physical therapy show that most interventions in these categories are characterized by a combination of passive and active components ( 20 - 23 ) . Although a combination of manual therapy or physical therapy that includes exercises appears to be effective for neck pain , these therapies have not been studied in sufficient detail to draw firm conclusions , and the method ologic quality of most trials on neck pain is rather low ( 20 - 23 ) . Koes and colleagues ( 24 , 25 ) performed a r and omized trial on back and neck pain and found promising results for manual therapy and physical therapy in subgroup analyses of patients with neck pain . In our r and omized , controlled trial , we compared the effectiveness of manual therapy , physical therapy , and continued care by a general practitioner in patients with nonspecific neck pain . Methods Patients Patients with nonspecific neck pain whose clinical presentation did not warrant referral for further diagnostic screening were referred to one of four research centers by 42 general practitioners for study selection . We excluded patients whose history , signs , and symptoms suggested a potential nonbenign cause ( including previous surgery of the neck ) or evidence of a specific pathologic condition , such as malignancy , neurologic disease , fracture , herniated disc , or systemic rheumatic disease . Two research assistants who were experienced physical therapists and were blinded to treatment allocation performed physical examinations at baseline and follow-up . They used st and ardized inclusion and exclusion criteria and performed a short neurologic examination ( Appendix Table 1 ) and range-of-motion assessment . The eligibility criteria were age between 18 and 70 years , pain or stiffness in the neck for at least 2 weeks , neck symptoms reproducible during physical examination , willingness to adhere to treatment and measurement regimens , no physical therapy or manual therapy for neck pain during the previous 6 months , no involvement in litigation , and written informed consent . Patients with concurrent headaches , nonradicular pain in the upper extremities , and low back pain were not excluded , but neck pain had to be the main symptom for all patients . R and om Assignment and Data Collection All patient data were collected before r and omization . Patients were assigned to a treatment group on the basis of block r and omization after prestratification for symptom severity ( severity scores < 7 points or 7 points on a scale of 0 to 10 ) ; age ( < 40 years or 40 years ) ; and , mainly for practical reasons , research center ( four local centers ) . R and omized permuted blocks of six patients were generated for each stratum by using a computer-generated r and om-sequence table . A research er who was not involved in the project prepared opaque , sequentially numbered sealed envelopes that contained folded cards indicating one of the three interventions . Interventions The intervention period lasted 6 weeks . Patients were allowed to perform exercises at home and to continue medication prescribed at baseline or use over-the-counter analgesics . Other co- interventions were discouraged but were registered if they occurred . Within the boundaries of the protocol , treatment could be reassessed and adapted to the patient 's condition . The specific treatment characteristics were registered at each visit . A maximum number of visits was set for each intervention group ; however , the patients did not have to complete this maximum number if symptoms had resolved . Manual Therapy Our approach to manual therapy was eclectic and incorporated several techniques used in western Europe , North America , and Australia , including those described by Cyriax , Kaltenborn , Maitl and , and Mennel ( 15 , 16 , 19 ) . In our trial , manual therapy ( defined as the use of passive movements to help restore normal spinal function ) included h and s-on muscular mobilization techniques ( aim ed at improving soft tissue function ) , specific articular mobilization techniques ( to improve overall joint function and decrease any restrictions in movement at single or multiple segmental levels in the cervical spine ) , and coordination or stabilization techniques ( to improve postural control , coordination , and movement patterns by using the stabilizing cervical musculature ) ( 26 ) . Joint mobilization is a form of manual therapy that involves low-velocity passive movements within or at the limit of joint range of motion ( 27 ) . Manual therapists must undergo extensive training to be able to skillfully perform mobilization techniques ( 15 , 19 ) . Spinal manipulations ( low-amplitude , high-velocity thrust techniques ) were not included in this protocol . Forty-five minute treatment sessions were scheduled once per week , for a maximum of six treatments . Six experienced manual therapists acknowledged by the Netherl and s Manual Therapy Association performed the treatment . Physical Therapy The physical therapists used a combination of several treatment options , but active exercise therapies were the cornerstone of their strategy . Active exercise therapy involves participation by the patient and includes active exercises ( to improve strength or range of motion ) ,  postural exercises , stretching , relaxation exercises  , and functional exercises . Manual traction or stretching , massage , or physical therapy methods , such as interferential current or heat applications , could precede the exercise therapy . Specific manual mobilization techniques were not included in this protocol . Thirty-minute treatment sessions were scheduled twice per week for a maximum of 12 treatments . The treatment was performed by five experienced physical therapists . We prevented cross-contamination with manual therapy by choosing physical therapists who were not manual therapy specialists . Continued Care by a General Practitioner Each patient in this group received st and ardized care from his or her general practitioner , including advice on prognosis , advice on psychosocial issues , advice on self-care ( heat application , home exercises ) , advice on ergonomics ( for example , size of pillow , work position ) , and encouragement to await further recovery . The treatment protocol was similar to the practice guidelines for low back pain issued by the Dutch College of General Practitioners ( 28 ) . Patients received an educational booklet containing ergonomic advice and exercises ( 29 ) . Medication , including paracetamol or nonsteroidal anti-inflammatory drugs , was prescribed on a time-contingent basis if necessary . Ten-minute follow-up visits , scheduled every 2 weeks , were optional , and referral during the intervention period was discouraged . Outcome Measures Data were collected at the research center after 3 and 7 weeks . At 7 weeks , treatment results were expected to be maximal . The patients were repeatedly asked not to reveal any information about their treatment allocation to the research assistants . The success of blinding was evaluated at 7 weeks . Primary outcome measures focused on perceived recovery , pain , and functional disability . Patients rated perceived recovery on a 6-point ordinal transition scale , ranging from much worse to completely recovered . Success was defined a priori as completely recovered or much improved ( 30 ) . In addition , on the basis of the systematic assessment of spinal mobility , palpation , and pain reported by Neck pain is more prevalent in office workers than in the general community . To date , findings from prospect i ve studies that investigated causal relationships between putative risk factors and the onset of neck pain in this population have been limited by high loss to follow-up . The aim of this research was to prospect ively evaluate a range of risk factors for neck pain in office workers , using vali date d and reliable objective measures as well as attain an estimate of 1-year incidence . We assembled a cohort of 53 office workers without neck pain and  measured individual , physical , workplace and psychological factors at  baseline . We followed participants for 1 year to measure the incidence of neck pain . We achieved 100 % participant follow-up . Cox regression analysis was applied to examine the relationship between the putative risk factors and the cumulative incidence of neck pain . The 1-year incidence proportion of  neck pain in Australian office workers was estimated in this study to be 0.49 ( 95 % CI 0.36–0.62 ) . Predictors of neck pain with moderate to large effect sizes were female gender ( HR : 3.07 ; 95 % CI : 1.18–7.99 ) and high psychological stress ( HR : 1.64 ; 95 % CI : 0.66–4.07 ) . Protective factors included increased mobility of the cervical spine ( HR : 0.44 ; 95 % CI : 0.19–1.05 ) and frequent exercise ( HR : 0.64 ; 95 % CI : 0.27–1.51 ) . These results reveal that neck pain is common in Australian office workers and that there are risk factors that are potentially modifiable Study Design . Population ‐based , cross‐sectional mailed survey . Objective . To determine the lifetime , period , and point prevalence of neck pain and its related disability among Saskatchewan adults and investigate the presence and strength of nonresponse bias . Summary of Background Data . In Europe , the life‐time and point prevalence of neck pain is almost as high as the prevalence of low back pain . Similarly , chronic neck pain is highly prevalent and a common source of disability in the working‐age population . However , no studies specifically have documented the prevalence of neck pain and its related disability in North America . Methods . The Saskatchewan Health and Back Pain Survey was mailed to 2184 r and omly selected Saskatchewan adults aged 20‐69 years . Fifty‐five percent of the study population participated . The presence of nonresponse bias was investigated through logistic regression and wave analysis . The Chronic Pain Question naire was used to classify the severity of chronic neck pain . Results . The age‐st and ardized lifetime prevalence of neck pain is 66.7 % ( 95 % confidence interval , 63.8‐69.5 ) , and the point prevalence is 22.2 % ( 95 % confidence interval , 19.7‐24.7 ) . The age‐st and ardized 6‐month prevalence of low‐intensity and low‐disability neck pain is 39.7 % ( 95 % confidence interval , 36.7‐42.7 ) , whereas it is 10.1 % ( 95 % confidence interval , 8.2‐11.9 ) for high‐intensity and low‐disability neck pain and 4.6 % ( 95 % confidence interval , 3.3‐5.8 ) for significantly disabling neck pain . The prevalence of low‐intensity and low‐disability neck pain decreases with age . More women experience high‐disability neck pain than men . Wave analysis suggests that the point prevalence and 6‐month prevalence of high‐intensity and low‐disability neck pain are overestimated in this survey . Conclusion . This cross‐sectional study shows that neck pain is highly prevalent in Saskatchewan and that it significantly disables 4.6 % ( 95 % confidence interval , 3.3‐5.8 ) of the adult population Study Design . A population cohort study to determine the 1-year persistence of neck pain . Objectives . The aim of this study was to determine the persistence of  neck pain  over a 12-month period among the general adult population and to explore socio-demographic , health-related , occupational , physical , and lifestyle factors that might be linked to such persistence . Summary of Background Data . Musculoskeletal clinicians report that neck patients frequently return to consult for recurring episodes of pain . However , the persistent nature of neck pain has been less research ed than other common chronic pain syndromes . Methods . First , to identify a cohort of current neck pain sufferers , a baseline cross-sectional survey was conducted in a general population of 7,669 adults , 18 to 75 years of age , registered with two primary care practice s in South Manchester , UK . The second phase was a follow-up survey , 12 months later , to determine the 1-year persistence of neck pain among those who had reported neck pain at baseline . Persistence of neck pain was compared across groups of responders stratified by potential prognostic factors measured at baseline . “ Persistent ” neck pain was defined according to shading within the region of the neck on a blank body mannequin . The term “ persistent ” neck pain could therefore reflect chronic , recurrent , or continuous pain . Results . There were 1,359 neck pain responders in the baseline survey , and these subjects formed the study population for the prospect i ve study . At follow-up , 786 ( 58 % ) subjects responded , of whom 48 % reported having neck pain lasting for more than 1 day , during the previous month . Significant baseline characteristics , which independently predicted persistent neck pain , were age ( odds ratio [ OR ] = 3.4 ) , being off work at the time of the baseline survey ( OR = 1.6 ) , comorbid low back pain ( OR = 1.6 ) , and cycling as a regular activity ( OR = 2.4 ) . Conclusion . Among the general population , neck pain persists at 12 months in around half of those who report neck pain at the start of the period . An increased risk of persistent neck pain was associated with age 45 to 59 years and low back pain , and also with cycling . The linkwith psychological distress and the absence of a link with occupational factors compares with other previous findings for common musculoskeletal syndromes in the community Aims : To quantify the relative contribution of work related physical factors , psychosocial workplace factors , and individual factors and aspects of somatisation to the onset of neck/shoulder pain .  Methods : Four year prospect i ve cohort study of workers from industrial and service companies in Denmark . Participants were 3123 workers , previously enrolled in a cross sectional study , where objective measurement of physical workplace factors was used . Eligible participants were followed on three subsequent occasions with approximately one year intervals . Outcomes of interest were : new onset of neck/shoulder pain ( symptom cases ) ; and neck/shoulder pain with pressure tenderness in the muscles of the neck/shoulder region ( clinical cases ) . Results : During follow up , 636 ( 14.1 % ) participants reported neck/shoulder pain of new onset ; among these , 82 ( 1.7 % ) also had clinical signs of substantial muscle tenderness . High shoulder repetition was related to being a future symptom case , and a future clinical case . Repetition was strongly intercorrelated with other physical measures . High job dem and s were associated with future status as a symptom case , and as a clinical case . A high level of distress predicted subsequent neck/shoulder pain , and neck/shoulder pain with pressure tenderness . Conclusions : High levels of distress , and physical and psychosocial workplace factors are predictors of onset of pain in the neck and /or shoulders , particularly pain with pressure tenderness in the muscles Study Design . A longitudinal study . Objectives . To estimate the prevalence and incidence of neck and shoulder pain in young adults and to identify the associated and predictive factors of neck and shoulder pain based on 7-year follow-up . Summary of Background Data . Several work-related , psychosocial , and sociodemographic factors have been verified as being related to neck and shoulder pain in adult population s , but far fewer longitudinal studies concerning the topic have been carried out in young population s. Methods . A r and om sample of 826 high school students was investigated when they were 15 to 18 years old and again at 22 to 25 years of age . Altogether , 394 ( 48 % ) patients participated in both surveys . The outcome variable was weekly neck and shoulder pain during the past 6 months in adulthood , and the explanatory variables included some sociodemographic factors , leisure time activities , self-assessed physical condition , psychosomatic stress symptoms , and symptoms of fatigue and sleep difficulties . Results . In 7 years , the prevalence of weekly neck and shoulder pain increased from 17 % to 28 % . Among those who were asymptomatic at baseline , 6-month incidence of occasional or weekly neck and shoulder pain was 59 % 7 years later . In an adjusted model , psychosomatic symptoms remained an associated factor for prevalent neck and shoulder pain 7 years later for both females and males . In females , neck and shoulder pain in adolescence was associated with prevalent neck and shoulder pain in adulthood , and sports loading dynamically in the upper extremities was an associated factor for a low prevalence of neck and shoulder pain 7 years later . In separate analyses of incident neck and shoulder pain , psychosomatic stress symptoms predicted neck and shoulder pain in adulthood . Conclusions . In young adults , the incidence of neck and shoulder pain is high , and the associated factors ofneck and shoulder pain are already multifactorial in a young population OBJECTIVES This study investigates the relationship between physical and psychosocial load at work and sickness absence due to  neck pain . METHODS A prospect i ve cohort study with a follow-up period of 3 years ( 1994 - 1998 ) was performed among a working population . At the beginning of the study , physical load at work was quantified by means of video recordings .  Work-related psychosocial variables were measured by means of the Job Content Question naire . The frequency of sickness absence due to neck pain with a minimal duration of 3 days was assessed on the basis of company registration s during the follow-up period . Altogether 758 workers were included in the analyses . Possible confounding by individual characteristics , physical load , and psychosocial load was studied . RESULTS Work-related neck flexion and neck rotation , low decision authority , and medium skill discretion showed statistically significant increased risks for sickness absence due to neck pain ( adjusted rate ratios ranging from 1.6 to 4.2 ) . High quantitative job dem and s , low skill discretion , and low job security showed nonsignificant increased risks for sickness absence due to neck pain ( adjusted rate ratios of 2.0 , 1.6 and 1.7 , respectively ) . Work-related sitting , conflicting job dem and s , supervisor support , and co-worker support did not increase sickness absence due to neck pain . CONCLUSION Work-related neck flexion , neck rotation , low decision authority , and medium skill discretion are risk factors for sickness absence due to neck pain . There are indications that high job dem and s , low skill discretion , and low job security are also risk factors for sickness absence due to neck pain The purpose of the present study was to assess five manual tests for pain provocation of the neck to determine their suitability for epidemiological investigations . To 75 r and omly selected men , five manual pain-provoking tests were applied in a single-blind design . Prevalence of reported neck dysfunction , sensitivity , specificity , and positive and negative predicted value for each test were calculated . 22 of the 75 reported present neck pain , while the remainder reported freedom from neck pain for at least one year . Palpation over the facet joints in the cervical spine was found to be the most appropriate screening test to corroborate the replies in self-reported question naires on dysfunctions of the neck . The outcome of this test was quite consistent with the reported neck pain . The test of the formina intervertebralia and the upper limb tension test caused pain in almost all subjects with reported neck dysfunctions , though not causing referred pain in the arm as an indication of neurogenous tissue origin , as it was aim ed to . Neither the neck rotation test nor the active flexion/extension test was sufficiently provocative to confirm the reported neck pain in these subjects , as both were insufficiently sensitive
Bearing in mind the limited number of studies and the low method ological quality , there are some indications that the localization ( radiation to the arms/neurologic signs ) and radiologic findings ( degenerative changes in the discs and joints ) are not associated with a worse prognosis .
A higher severity of pain and a history of previous attacks however , seems to be associated with a worse prognosis
Neck pain occurs frequently in western societies .
In the majority of cases , no specific cause can be identified .
In order to gain insight into the clinical course and prognostic factors of non-specific neck pain , a systematic review was conducted .