title: Simple neck pain questions used in surveys, evaluated in relation to health outcomes: a cohort study.
abstract: BACKGROUND
  The high prevalence of pain reported in many epidemiological studies, and the degree to which this prevalence reflects severe pain is under discussion in the literature. The aim of the present study was to evaluate use of the simple neck pain questions commonly included in large epidemiological survey studies with respect to aspects of health. We investigated if and how an increase in number of days with pain is associated with reduction in health outcomes.
  
  
  METHODS
  A cohort of university students (baseline age 19-25 years) were recruited in 2002 and followed annually for 4 years. The baseline response rate was 69% which resulted in 1200 respondents (627 women, 573 men). Participants were asked about present and past pain and perceptions of their general health, sleep disturbance, stress and energy levels, and general performance. The data were analyzed using a mixed model for repeated measurements and a random intercept logistic model.
  
  
  RESULTS
  When reporting present pain, participants also reported lower prevalence of very good health, higher stress and sleep disturbance scores and lower energy score. Among those with current neck pain, additional questions characterizing the pain such as duration (categorized), additional pain sites and decreased general performance were associated with lower probability of very good health and higher amounts of sleep disturbance. Knowing about the presence or not of pain explains more of the variation in health between individuals, than within individuals.
  
  
  CONCLUSIONS
  This study of young university students has demonstrated that simple neck pain survey questions capture features of pain that affect aspects of health such as perceived general health, sleep disturbance, mood in terms of stress and energy. Simple pain questions are more useful for group descriptions than for describing or following pain in an individual.
authors.affiliation: Department of Public Health and Community Medicine, Sahlgrenska Academy and University Hospital, Box 414, Göteborg, SE-405 30, Sweden. anna.ekman@amm.gu.se
authors.forename: Anna
authors.initials: A
authors.lastname: Grimby-Ekman
authors.forename: Mats
authors.initials: M
authors.lastname: Hagberg
mesh_terms: D000328:Adult; D000339:Affect; D017281:Cost of Illness; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D019547:Neck Pain / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement; D058748:Pain Perception; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult