Advertisement

Psychosocial, Physical, and Neurophysiological Risk Factors for Chronic Neck Pain: A Prospective Inception Cohort Study

  • Bahar Shahidi
    Affiliations
    Physical Therapy and Rehabilitation Science Programs, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado
    Search for articles by this author
  • Douglas Curran-Everett
    Affiliations
    Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, Colorado
    Search for articles by this author
  • Katrina S. Maluf
    Correspondence
    Address reprint requests to Katrina S. Maluf, PT, PhD, School of Exercise and Nutritional Sciences, Doctor of Physical Therapy Program, College of Health & Human Services, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-7251.
    Affiliations
    Physical Therapy and Rehabilitation Science Programs, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado

    Physical Therapy Program, School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California
    Search for articles by this author
Published:September 20, 2015DOI:https://doi.org/10.1016/j.jpain.2015.09.002

      Highlights

      • Psychosocial, physical, and neurophysiological factors affected the risk for neck pain.
      • Depressed mood was the strongest predictor for development of chronic neck pain.
      • Diffuse noxious inhibitory control was impaired in those developing chronic neck pain.
      • Poor cervical extensor endurance increased the risk for developing chronic neck pain.

      Abstract

      The purpose of this investigation was to identify modifiable risk factors for the development of first-onset chronic neck pain among an inception cohort of healthy individuals working in a high-risk occupation. Candidate risk factors identified from previous studies were categorized into psychosocial, physical, and neurophysiological domains, which were assessed concurrently in a baseline evaluation of 171 office workers within the first 3 months of hire. Participants completed monthly online surveys over the subsequent year to identify the presence of chronic interfering neck pain, defined as a Neck Disability Index score ≥5 points for 3 or more months. Data were analyzed using backward logistic regression to identify significant predictors within each domain, which were then entered into a multivariate regression model adjusted for age, sex, and body mass index. Development of chronic interfering neck pain was predicted by depressed mood (odds ratio [OR] = 3.36, 95% confidence interval [CI] = 1.10–10.31, P = .03), cervical extensor endurance (OR = .92, 95% CI, .87–.97, P = .001), and diffuse noxious inhibitory control (OR = .90, 95% CI, .83–.98, P = .02) at baseline. These findings provide the first evidence that individuals with preexisting impairments in mood and descending pain modulation may be at greater risk for developing chronic neck pain when exposed to peripheral nociceptive stimuli such as that produced during muscle fatigue.

      Perspective

      Depressed mood, poor muscle endurance, and impaired endogenous pain inhibition are predisposing factors for the development of new-onset chronic neck pain of nonspecific origin in office workers. These findings may assist with primary prevention by allowing clinicians to screen for individuals at risk of developing chronic neck pain.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Pain
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Andersen J.
        • Kaergaard A.
        • Frost P.
        • Thomsen J.F.
        • Bonde J.P.
        • Fallentin N.
        • Borg V.
        • Mikkelsen S.
        Physical, psychosocial, and individual risk factors for neck/shoulder pain with pressure tenderness in the muscles among workers performing monotonous, repetitive work.
        Spine. 2002; 27: 660-667
        • Ariens G.
        • van Mechelen W.
        • Bongers P.
        • Bouter L.
        • van der Wal G.
        Physical risk factors for neck pain.
        Scand J Work Environ Health. 2000; 26: 7-19
        • Baecke J.
        • Burena J.
        • Frijters J.
        A short questionnaire for the measurement of habitual physical activity in epidemiological studies.
        Am J Clin Nutr. 1982; 36: 936-942
        • Barnekow-Bergkvist M.
        • Hedberg G.
        • Janlert U.
        • Jansson E.
        Determinants of self-reported neck-shoulder and low back symptoms in a general population.
        Spine. 1998; 23: 235-243
        • Basbaum A.
        • Bushnell C.
        Science of Pain.
        Elsevier, Boston, MA2009
        • Beck A.
        • Steer R.
        • Ball R.
        • Ranieri W.
        Comparison of Beck Depression Inventories-IA and –II in Psychiatric Outpatients.
        J Personality Assess. 1996; 67: 588-597
        • Bishop-Bailey D.
        Mechanisms governing the health and performance benefits of exercise.
        Br J Pharmacol. 2013; 170: 1153-1166
        • Bongers P.
        • Winter C.
        • Kompier M.
        • Hidebrandt V.
        Psychosocial factors at work and musculoskeletal disease.
        Scand J Work Environ Health. 1993; 19: 297-312
        • Borghouts J.A.
        • Koes B.W.
        • Vondeling H.
        • Bouter L.M.
        Cost-of-illness of neck pain in The Netherlands in 1996.
        Pain. 1999; 80: 629-636
        • Brandt L.
        • Andersen J.
        • Lassen C.
        • Kryger A.
        • Overgaard E.
        • Vilstrup I.
        • Mikkelsen S.
        Neck and shoulder symptoms and disorders among Danish computer workers.
        Scand J Work Environ Health. 2004; 30: 399-409
        • Carroll L.
        • Cassidy D.
        • Cote P.
        Depression as a risk factor for onset of an episode of troublesome neck and low back pain.
        Pain. 2004; 107: 134-139
        • Cathcart S.
        • Winefield A.
        • Roan P.
        • Lushington K.
        Reliability of temporal summation and diffuse noxious inhibitory control.
        Pain Res Manag. 2009; 14: 433-438
        • Chitour D.
        • Dickenson A.
        • Le Bars D.
        Pharmacological evidence for the involvement of serotonergic mechanisms in diffuse noxious inhibitory controls (DNIC).
        Brain Res. 1982; 236: 329-337
        • Cohen S.
        • Kamarck T.
        • Mermelstein R.
        A global measure of perceived stress.
        J Health Soc Behav. 1983; 24: 385-396
        • Cote P.
        • Cassidy J.D.
        • Carroll L.J.
        • Kristman V.
        The annual incidence and course of neck pain in the general population: a population-based cohort study.
        Pain. 2004; 112: 267-273
        • Cote P.
        • van der Velde G.
        • Cassidy J.D.
        • Carroll L.J.
        • Hogg-Johnson S.
        • Holm L.W.
        • Carragee E.J.
        • Haldeman S.
        • Nordin M.
        • Hurwitz E.L.
        • Guzman J.
        • Peloso P.M.
        The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.
        J Manipulative Physiol Ther. 2008; 32: S70-S86
        • Craney T.
        • Surles J.
        Model-dependent variance inflation factor cutoff values.
        Qual Eng. 2007; 14: 391-403
        • Da Costa B.
        • Vieira E.
        Risk factors for work-related musculoskeletal disorders: a systematic review of recent longitudinal studies.
        Am J Ind Med. 2010; 53: 1-39
        • Diatchenko L.
        • Fillingimm R.
        • Smith S.
        • Maixneer W.
        The phenotypic and genetic signatures of common musculoskeletal pain conditions.
        Nat Rev Rheumatol. 2013; 9: 340-350
        • Eltayeb S.
        • Staal J.
        • Hassan A.
        • de Bie R.
        Work related risk factors for neck, shoulder and arms complaints: a cohort study among Dutch computer office workers.
        J Occup Rehabil. 2009; 19: 315-322
        • Gerdle B.
        • Kristiansen J.
        • Larsson B.
        • Saltin B.
        • Sogaard K.
        • Sjogaard G.
        Algogenic substances and metabolic status in work-related Trapezius myalgia: a multivariate explorative study.
        BMC Musculoskelet Disord. 2014; 15: 357
        • Gore M.
        • Sadosky A.
        • Stacey B.R.
        • Tai K.S.
        • Leslie D.
        The burden of chronic low back pain: clinical comorbidities, treatment patterns, and health care costs in usual care settings.
        Spine. 2012; 37: E668-E677
        • Graven-Nielsen T.
        • Mense S.
        The peripheral apparatus of muscle pain: evidence from animal and human studies.
        Clin J Pain. 2001; 17: 2-10
        • Grimby-Ekman A.
        • Andersson E.
        • Hagberg M.
        Analyzing musculoskeletal neck pain, measured as present pain and periods of pain, with three different regression models: a cohort study.
        BMC Musculoskelet Disord. 2009; 10: 73
        • Guzman J.
        • Hurwitz E.L.
        • Carroll L.J.
        • Haldeman S.
        • Cote P.
        • Carragee E.J.
        • Peloso P.M.
        • van der Velde G.
        • Holm L.W.
        • Hogg-Johnson S.
        • Nordin M.
        • Cassidy J.D.
        A new conceptual model of neck pain: linking onset, course, and care: the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.
        Spine. 2008; 33: S14-S23
        • Hamberg van Reenen H.
        • Ariens G.
        • Blatter B.
        • van der Beek J.
        • Twisk W.
        • Mechellen W.
        • Bongers P.
        Is an imbalance between physical capacity and exposure to work-related physical factors associated with low-back, neck or shoulder pain?.
        Scand J Work Environ Health. 2006; 32: 190-197
        • Hansson G.
        • Nordander C.
        • Asterland P.
        • Ohlsson K.
        • Stromberg U.
        • Skerfing S.
        • Rempel D.
        Sensitivity of trapezius electromyography to differences between work tasks-influence of gap definition and normalization methods.
        J Electromyogr Kinesiol. 2000; 10: 103-115
        • Hanvold T.
        • Waersted M.
        • Mengshoel A.
        • Bjerness E.
        • Stigum H.
        • Twisk J.
        • Veiersted K.
        The effect of work-related sustained trapezius muscle activity on the development of neck and shoulder pain among young adults.
        Scand J Work Environ Health. 2014; 39: 390-400
        • Hilderink P.
        • Burger H.
        • Deeg D.
        • Beekman A.
        • Oude Voshaar R.
        The temporal relation between pain and depression: results from the longitudinal aging study Amsterdam.
        Psychosom Med. 2012; 74: 945-951
        • Hogg-Johnson S.
        • van der Velde G.
        • Carroll L.J.
        • Holm L.W.
        • Cassidy J.D.
        • Guzman J.
        • Cote P.
        • Haldeman S.
        • Ammendolia C.
        • Carragee E.
        • Hurwitz E.
        • Nordin M.
        • Peloso P.
        The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.
        J Manipulative Physiol Ther. 2008; 32: S46-S60
        • Hoy D.
        • March L.
        • Woolf A.
        • Blyth F.
        • Brooks P.
        • Smith E.
        • Vos T.
        • Barendregt J.
        • Blore J.
        • Murray C.
        • Burstein R.
        • Buchbinder R.
        The global burden of neck pain: estimates from the global burden of disease 2010 study.
        Ann Rheum Dis. 2008; 73: 1309-1315
        • Hush J.
        • Michaleff Z.
        • Maher C.H.
        • Refshauge K.
        Individual, physical and psychological risk factors for neck pain in Australian office workers: a 1-year longitudinal study.
        Eur Spine J. 2009; 18: 1532-1540
        • Julien N.
        • Goffaux P.
        • Arsenault P.
        • Marchand S.
        Widespread pain in fibromyalgia is related to a deficit of endogenous pain inhibition.
        Pain. 2005; 114: 295-302
        • Kanchanomai S.
        • Janwantanakul P.
        • Pensri P.
        • Jiamjarasrangsi W.
        Risk factors for the onset and persistence of neck pain in undergraduate students: 1-year prospective cohort study.
        BMC Public Health. 2011; 11: 566
        • Karasek R.
        • Brisson C.
        • Kawakami N.
        • Houtman I.
        • Bongers P.
        • Amich B.
        The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics.
        J Occup Health Psychol. 1998; 3: 322-355
        • Korhonen T.
        • Ketola R.
        • Toivonen R.
        • Luukkonen R.
        • Hakkanen M.
        • Viikari-Juntura E.
        Work related and individual predictors for incident neck pain among office employees working with video display units.
        Occup Environ Med. 2003; 60: 475-482
        • Kraatz S.
        • Lang J.
        • Kraus T.
        • Munster E.
        • Ochsmann E.
        The incremental effect of psychosocial workplace factors on the development of neck and shoulder disorders: a systematic review of longitudinal studies.
        Int Arch Occup Environ Health. 2013; 86: 375-395
        • Leeuw M.
        • Goossens M.
        • Linton S.
        • Crombez G.
        • Boersma K.
        • Vlaeyen J.
        The fear-avoidance model of musculoskeletal pain: a current state of scientific evidence.
        J Behav Med. 2007; 30: 77-94
        • Lewis G.
        • Heales L.
        • Rice D.
        • Rome K.
        • McNair P.
        Reliability of the conditioned pain modulation paradigm to assess endogenous inhibitory pain pathways.
        Pain Res Manag. 2012; 17: 98-102
        • Linton S.
        A review of psychological risk factors in back and neck pain.
        Spine. 2000; 9: 1148-1156
        • Lovibond P.
        • Lovibond S.
        The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories.
        Behav Res Ther. 1995; 33: 335-343
        • Maixner W.
        • Fillingim R.
        • Booker D.
        • Sigurdsson A.
        Sensitivity of patients with painful temporomandibular disorders to experimentally evoked pain.
        Pain. 1995; 63: 341-351
        • Manchikanti L.
        • Singh V.
        • Datta S.
        • Cohen S.P.
        • Hirsch J.A.
        Comprehensive review of epidemiology, scope, and impact of spinal pain; American Society of Interventional Pain Physicians.
        Pain Physician. 2009; 12: E35-E70
        • Mantyselka P.
        • Lupsakko T.
        • Kautiainen H.
        • Vanhala M.
        Neck-shoulder pain and depressive symptoms: a cohort study with a 7-year follow up.
        Eur J Pain. 2010; 14: 189-193
        • Martin B.I.
        • Deyo R.A.
        • Mirza S.K.
        • Turner J.A.
        • Comstock B.A.
        • Hollingworth W.
        • Sullivan S.D.
        Expenditures and health status among adults with back and neck problems.
        JAMA. 2008; 299: 656-664
        • Moloney N.
        • Hall T.
        • Doody C.
        Reliability of thermal quantitative sensory testing: A systematic review.
        J Rehabil Res Dev. 2012; 49: 191-208
        • Paksaichol A.
        • Janwantanakul P.
        • Lawsirirat C.
        Development of a neck pain risk score for predicting nonspecific neck pain with disability in office workers: a 1-year prospective cohort study.
        J Manipulative Physiol Ther. 2014; 37: 468-475
        • Paksaichol A.
        • Janwantanakul P.
        • Purepong N.
        • Pensri P.
        • van der Beek A.
        Office workers’ risk factors for the development of non-specific neck pain: a systematic review of prospective cohort studies.
        Occup Environ Med. 2012; 69: 610-618
        • Palmer K.
        • Syddall H.
        • Cooper C.
        • Coggon D.
        Smoking and musculoskeletal disorders: findings from a British national survey.
        Ann Rheum Dis. 2003; 62: 33-36
        • Pielsticker A.
        • Haag G.
        • Zaudig M.
        • Lautenbacher S.
        Impairment of pain inhibition in chronic tension-type headache.
        Pain. 2005; 118: 215-223
        • Quartana P.
        • Campbell C.
        • Edwards R.
        Pain catastrophizing: a critical review.
        Expert Rev Neurother. 2009; 9: 745-758
        • Shahidi B.
        • Johnson C.
        • Curran-Everett D.
        • Maluf K.
        Reliability and group differences in quantitative cervicothoracic measures among individuals with and without chronic neck pain.
        BMC Musculoskelet Disord. 2012; 13: 215
        • Sjors A.
        • Larsson B.
        • Persson A.
        • Gerdle B.
        An increased response to experimental muscle pain is related to psychological status in women with chronic non-traumatic neck-shoulder pain.
        BMC Musculoskelet Disord. 2011; 12: 230
        • Slade G.
        • Sanders A.
        • Ohrbach R.
        • Fillingim R.
        • Dubner R.
        • Gracely R.
        • Bair E.
        • Maixner W.
        • Greenspan J.
        Pressure pain thresholds fluctuate with, but do not usefully predict, the clinical course of painful temporomandibular disorder.
        Pain. 2014; 155: 2134-2143
        • Sluka K.
        Mechanisms and management of pain for the physical therapist.
        IASP Press, Seattle2009
        • Spielberger C.D.
        • Gorsuch R.L.
        State-Trait Anxiety Inventory for adults: Manual and sample: Manual, Instrument and Scoring Guide.
        Consulting Psychologists Press, Palo Alto1983
        • Spielberger C.D.
        • Gorsuch R.L.
        • Lushene R.E.
        Manual for the State-Trait Inventory.
        Consulting Psychologists Press, Palo Alto1970
        • Stanley M.
        • Beck J.
        • Zebb B.
        Psychometric properties of 4 anxiety measures in older adults.
        Behav Res Ther. 1996; 34: 827-838
        • Sterud T.
        • Johannessen H.A.
        • Tynes T.
        Work-related psychosocial and mechanical risk factors for neck/shoulder pain: a 3-year follow-up study of the general working population of Norway.
        Int Arch Occup Environ Health. 2014; 87: 471-481
        • Stewart W.F.
        • Ricci J.A.
        • Chee E.
        • Morganstein D.
        • Lipton R.
        Lost productive time and cost due to common pain conditions in the US workforce.
        JAMA. 2003; 290: 2443-2454
        • Stratford P.W.
        • Riddle D.L.
        • Binkley J.M.
        • Spadoni G.
        • Westaway M.D.
        • Padfield B.
        Using the Neck Disability Index to make decisions concerning individual patients.
        Physiother Can. 1999; 51: 107-112
        • Sullivan M.J.
        • Bishop S.R.
        • Pivik J.
        The pain catastrophizing scale: development and validation.
        Psychol Assess. 1995; 7: 524-532
        • van Tulder M.
        • Furlan A.
        • Bombardier C.
        • Bouter L.
        Updated method guidelines for systematic reviews in the Cochrane Collaboration back review group.
        Spine. 2003; 28: 1290-1299
        • Vlaeyen J.
        • Linton S.
        Fear-avoidance model of chronic musculoskeletal pain: 12 years on.
        Pain. 2012; 153: 1144-1147
        • Walton D.M.
        • Macdermid J.C.
        • Nielson W.
        • Teasell R.W.
        • Chiasson M.
        • Brown L.
        Reliability, standard error, and minimum detectable change of clinical pressure pain threshold testing in people with and without acute neck pain.
        J Orthop Sports Phys Ther. 2011; 41: 644-650
        • Wang Y.
        • Gorenstein C.
        Psychometric properties of the Beck Depression Inventory-II: a comprehensive review.
        Rev Bras Psiquiatr. 2013; 35: 416-431
        • Weiss D.
        • Dawis R.
        • England G.
        Manual for the Minnesota Satisfaction Questionnaire.
        Minnesota Studies in Vocational Rehabilitation. 1967; 22: 120
        • Yarnitsky D.
        Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states.
        Curr Opin Anaesthesiol. 2010; 23: 611-615