Characteristics of a new episode of neck pain

Andrew M. Leaver, Christopher G. Maher, James H. McAuley, Gwendolen A. Jull, Kathryn M. Refshauge

We report on the demographic and clinical characteristics of patients seeking manual therapy care for a new episode of non-specific neck pain and report on characteristics associated with higher levels of pain and disability in these patients. Demographic and clinical data were collected from patients who enrolled in a clinical trial of manipulation for neck pain. A profile of these patients was formulated using descriptive statistics. Multivariate linear regression models were used to describe the relationship between patient characteristics and severity of pain and disability. Patients with a new episode of non-specific neck pain reported pain intensity of 6.1 ± 2.0 (mean ± SD) on a 0-10 numerical scale and disability scores of 15.7 ± 7.4 (Neck Disability Index/50). Sixty-three percent had a prior history of neck pain. Concomitant symptoms were highly prevalent including upper limb pain (80%), headache (65%), upper back pain (64%), lower back pain (39%), dizziness (31%) and nausea (23%). There was a strong association between pain intensity and disability (p < 0.01). More severe pain was also associated with not having concomitant back pain (p = 0.01) More severe disability was also associated with poor general health (p < 0.01), nausea (p < 0.01), smoking, (p = 0.02) low SF-12 mental health score (p = 0.02), and shorter duration of symptoms (p = 0.03). Patients with a new episode of neck pain, and deemed suitable for treatment with neck manipulation reported moderately high intensity pain and disability with widespread and frequent concomitant symptoms.