title: Prognosis of acute idiopathic neck pain is poor: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To conduct a systematic review and meta-analysis on the prognosis of acute idiopathic neck pain and disability.
  
  
  METHODS
  EMBASE, CINAHL, Medline, AMED, PEDro, and CENTRAL were searched from inception to July 2009, limited to human studies. Reference lists of relevant systematic reviews were searched by hand. Search terms included: neck pain, prognosis, inception, cohort, longitudinal, observational, or prospective study and randomized controlled trial.
  
  
  METHODS
  Eligible studies were longitudinal cohort studies and randomized controlled trials with a no treatment or minimal treatment arm that recruited an inception cohort of acute idiopathic neck pain and reported pain or disability outcomes. Eligibility was determined by 2 authors independently. Seven of 20,085 references were included.
  
  
  METHODS
  Pain and disability data were extracted independently by 2 authors. Risk of bias was assessed independently by 2 authors.
  
  
  RESULTS
  Statistical pooling showed a weighted mean pain score (0-100) of 64 (95% confidence interval [CI], 61-67) at onset and 35 (95% CI, 32-38) at 6.5 weeks. At 12 months, neck pain severity remained high at 42 (95% CI, 39-45). Disability reduced from a pooled weighted mean score (0-100) at onset of 30 (95% CI, 28-32) to 17 (95% CI, 15-19) by 6.5 weeks, without further improvement at 12 months. Studies varied in length of follow-up, design, and sample size.
  
  
  CONCLUSIONS
  This review provides Level I evidence that the prognosis of acute idiopathic neck pain is worse than currently recognized. This evidence can guide primary care clinicians when providing prognostic information to patients. Further research to identify prognostic factors and long-term outcomes from inception cohorts would be valuable.
authors: Discipline of Physiotherapy, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia. Julia.hush@sydney.edu.au
authors: Julia M
authors: JM
authors: Hush
authors: C Christine
authors: CC
authors: Lin
authors: Zoe A
authors: ZA
authors: Michaleff
authors: Arianne
authors: A
authors: Verhagen
authors: Kathryn M
authors: KM
authors: Refshauge
mesh_terms: D000208:Acute Disease; D004185:Disability Evaluation; D006801:Humans; D019547:Neck Pain / Q000175:diagnosis* / Q000534:rehabilitation; D011320:Primary Health Care; D011379:Prognosis