Prognostic factors for progressive non-specific neck pain: a systematic review

Abstract

Neck pain is one of the four most commonly reported musculoskeletal disorders in the UK. Little is known about which individual neck pain sufferer goes on to have recurrent, persistent or disabling neck pain. The development and persistence of non-specific neck symptoms are thought to be related to multiple factors. This systematic review investigated the prognostic factors that may constitute a risk for recurrent, persistent or disabling problems in patients who suffer from non-specific neck pain. It included prospective studies with a minimum of 1-year follow-up period and excluded cross-sectional and case-control studies. Nine studies were included. Eight were assessed as high quality and one as lower quality. This review found strong evidence of unfavourable outcome associated with older age, a longer duration of the current episode of neck pain, a previous history of neck problems, co-existing shoulder problems and other musculoskeletal disorders. There was conflicting evidence that baseline measures of pain and disability predicted outcome. There was strong evidence that regular exercise predicted a good outcome. This evidence about prognostic indicators can guide clinicians to provide advice or treatment which may help to prevent persistent neck problems. There is an absence of high-quality research investigating the predictive nature of psychological and sociodemographic factors. This has implications for clinical practice and research alike.