Course and prognostic factors for neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.
METHODS
Best evidence synthesis.


OBJECTIVE
To undertake a best evidence synthesis on course and prognosis of neck pain and its associated disorders in the general population.


BACKGROUND
Knowing the course of neck pain guides expectations for recovery. Identifying prognostic factors assists in planning public policies, formulating interventions, and promoting lifestyle changes to decrease the burden of neck pain.


METHODS
The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) conducted a critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Findings from studies meeting criteria for scientific validity were abstracted into evidence tables and included in a best evidence synthesis.


RESULTS
We found 226 articles on the course and prognostic factors in neck pain and its associated disorders. After critical review, 70 (31%) of these were accepted on scientific merit. Six studies related to course and 7 to prognostic factors in the general population. Between half and three quarters of persons in these populations with current neck pain will report neck pain again 1 to 5 years later. Younger age predicted better outcome. General exercise was unassociated with outcome, although regular bicycling predicted poor outcome in 1 study. Psychosocial factors, including psychologic health, coping patterns, and need to socialize, were the strongest prognostic factors. Several potential prognostic factors have not been well studied, including degenerative changes, genetic factors, and compensation policies.


CONCLUSIONS
The Neck Pain Task Force undertook a best evidence synthesis to establish a baseline of the current best evidence on the course and prognosis for this symptom. General exercise was not prognostic of better outcome; however, several psychosocial factors were prognostic of outcome.
Carroll
Linda J
LJ
Department of Public Health Sciences, School of Public Health, University of Alberta, Alberta, Canada. lcarroll@ualberta.ca
Hogg-Johnson
Sheilah
S
van der Velde
Gabrielle
G
Haldeman
Scott
S
Holm
Lena W
LW
Carragee
Eugene J
EJ
Hurwitz
Eric L
EL
Côté
Pierre
P
Nordin
Margareta
M
Peloso
Paul M
PM
Guzman
Jaime
J
Cassidy
J David
JD