Best Evidence on the Burden and Determinats of Neck Pain
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

https://doi.org/10.1016/j.jmpt.2008.11.012Get rights and content

Abstract

Study Design

Systematic review and best evidence synthesis.

Objectives

To describe the prevalence and incidence of neck pain and disability in workers; to identify risk factors for neck pain in workers; to propose an etiological diagram; and to make recommendations for future research.

Summary of Background Data

Previous reviews of the etiology of neck pain in workers relied on cross-sectional evidence. Recently published cohorts and randomized trials warrant a re-analysis of this body of research.

Methods

We systematically searched Medline for literature published from 1980–2006. Retrieved articles were reviewed for relevance. Relevant articles were critically appraised. Articles judged to have adequate internal validity were included in our best evidence synthesis.

Results

One hundred and nine papers on the burden and determinants of neck pain in workers were scientifically admissible. The annual prevalence of neck pain varied from 27.1% in Norway to 47.8% in Québec, Canada. Each year, between 11% and 14.1% of workers were limited in their activities because of neck pain. Risk factors associated with neck pain in workers include age, previous musculoskeletal pain, high quantitative job demands, low social support at work, job insecurity, low physical capacity, poor computer workstation design and work posture, sedentary work position, repetitive work and precision work. We found preliminary evidence that gender, occupation, headaches, emotional problems, smoking, poor job satisfaction, awkward work postures, poor physical work environment, and workers' ethnicity may be associated with neck pain. There is evidence that interventions aimed at modifying workstations and worker posture are not effective in reducing the incidence of neck pain in workers.

Conclusion

Neck disorders are a significant source of pain and activity limitations in workers. Most neck pain results from complex relationships between individual and workplace risk factors. No prevention strategies have been shown to reduce the incidence of neck pain in workers.

Section snippets

Design and Data Collection

We conducted a systematic review of the literature. The literature search and critical review strategy are outlined in detail elsewhere in this report.11 Briefly, we systematically searched the electronic library database Medline for literature published from 1980 through 2006 on neck pain and its associated disorders (e.g., cervicogenic headache and other referred pain syndromes into the arm and upper back). We also systematically checked reference lists of relevant articles and updated our

Selection and Critical Appraisal of Articles

Overall, the Task Force retrieved 31,878 citations, of which 1203 met the inclusion criteria for relevance to the Neck Pain Task Force and were reviewed.11 Six hundred and fifty-one articles were excluded because they were appraised as scientifically inadmissible by the Scientific Secretariat of the Neck Pain Task Force.11 Of the 552 scientifically admissible articles, 469 related to the incidence, risk factors, prevalence and factors associated with prevalent neck pain: 109 of these articles

Discussion

Our systematic review demonstrates that neck pain is a significant health problem in workers. Each year, it can be expected that at least five percent of the working population will develop frequent or persistent neck disorders and that depending on their occupations, up to 10% will probably experience at least one episode of activity limitations because of neck pain.

The evidence suggests that most neck pain in workers is nontraumatic and that its etiology is multifaceted. While the evidence

Conclusion

In the introduction to this paper, we highlighted 3 questions that are relevant to all stakeholders invested in occupational health. We believe that our systematic review of the evidence regarding neck pain in workers has yielded answers to these questions:

Acknowledgments

We are indebted to Ms. Oksana Colson and Ms. Leah Phillips (M.A.) for their administrative assistance; to Mr. Stephen Greenhalgh (M.A., MLIS), Ms. C. Sam Cheng (MLIS) and Ms. Lori Giles-Smith (MLIS), research librarians, for their assistance in the work of the Neck Pain Task Force; and to Ms. Evelyne Michaels for her assistance in editing the manuscripts. We also thank Drs. Heather Shearer and Maja Stupar with their assistance in preparing this manuscript. The Bone and Joint Decade 2000–2010

References (134)

  • WaddellG et al.

    Back pain, incapacity for work and social security benefits: an international literature review and analysis. Social security in individual countries

    The Royal Society of Medicine Press

    (2002)
  • SilversteinBA et al.

    Use of a prevention index to identify industries at high risk for work-related musculoskeletal disorders of the neck, back, upper extremity in Washington State, 1990–1998

    Am J of Industrial Med

    (2002)
  • CôtéP et al.

    The prevalence and incidence of work absenteeism involving neck pain: a cohort of Ontario lost-time claimants

    Spine

    (2008)
  • CarrollLJ et al.

    Course and prognostic factors for neck pain in workers. Results of the Bone and Joint Decade 2000 –2010 Task Force on Neck Pain and Its Associated Disorders

    Spine

    (2008)
  • NordinM et al.

    Assessment of neck pain and its associated disorders. Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

    Spine

    (2008)
  • Putz-Anderson V, Bernard BP, Burt S, et al. Musculoskeletal disorders and workplace factors: introduction and neck...
  • AriensGA et al.

    Physical risk factors for neck pain

    Scandinavian J of Work, Enviro & Health

    (2000)
  • AriensGA et al.

    Psychosocial risk factors for neck pain: a systematic review

    Am J of Industrial Med

    (2001)
  • SpitzerWO

    Scientific approach to the assessment and management of activity-related spinal disorders. A mongraph for clinicians

    Spine

    (1987)
  • CarrollLJ et al.

    Methods for the best evidence synthesis on neck pain and its associated disorders. The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

    Spine

    (2008)
  • van der VeldeG et al.

    The sensitivity of review results to methods used to appraise and incorporate trial quality into data synthesis

    Spine

    (2007)
  • SlavinRE

    Best evidence synthesis: an alternative to meta-analytic and traditional reviews

    Educational Researcher

    (1986)
  • AltmanDG et al.

    Methodological challenges in the evaluation of prognostic factors in breast cancer

    Breast Cancer Research & Treatment

    (1998)
  • CôtéP et al.

    A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature

    Spine

    (2001)
  • CarrollLJ et al.

    Prognosis for mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury

    Journal of Rehabilitation Medicine.

    (2004)
  • CarrollLJ et al.

    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

    Spine

    (2008)
  • CarrollLJ et al.

    Course and prognostic factors for neck pain in whiplash-associated disorders (WAD). Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

    Spine

    (2008)
  • Hogg-JohnsonS et al.

    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

    Spine

    (2008)
  • HolmLW et al.

    The burden and determinants of whiplash-associated disorders after traffic collisions: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

    Spine

    (2008)
  • KuzmaJW

    Basic Statistics for the Health Sciences

    (1998)
  • AkessonI et al.

    Musculoskeletal symptoms among dental personnel; - lack of association with mercury and selenium status, overweight and smoking

    Swedish Dental Journal

    (2000)
  • AlexopoulosEC et al.

    Risk factors for musculoskeletal disorders among nursing personnel in Greek hospitals

    Int Arch Occup Environ Health

    (2003)
  • CromieJE et al.

    Work-related musculoskeletal disorders in physical therapists: prevalence, severity, risks, responses

    Physical Therapy

    (2000)
  • de ZwartBC et al.

    Musculoskeletal complaints in The Netherlands in relation to age, gender and physically demanding work

    International Archives of Occupational & Environ Health

    (1997)
  • EriksenW

    The prevalence of musculoskeletal pain in Norwegian nurses aides

    Int Arch Occup Environ Health

    (2003)
  • Fjellman-WiklundA et al.

    Physical and psychosocial work-related risk factors associated with neck-shoulder discomfort in male and female music teachers

    Medical Problems of Performing Artists.

    (2003)
  • FriedrichM et al.

    Spinal troubles in sewage workers: epidemiological data and work disability due to low back pain

    International Archives of Occup & Environ Health

    (2000)
  • GamperieneM et al.

    Work related risk factors for musculoskeletal complaints in the spinning industry in Lithuania

    Occup & Environ Med

    (1999)
  • HagenKB et al.

    Neck/shoulder and low-back disorders in the forestry industry: relationship to work tasks and perceived psychosocial job stress

    Ergonomics

    (1998)
  • LipscombJA et al.

    Work-schedule characteristics and reported musculoskeletal disorders of registered nurses

    Scandinavian J of Work, Environ & Health

    (2002)
  • MolanoSM et al.

    Factors associated with medical care- seeking due to low-back pain in scaffolders

    Am J of Industrial Med

    (2001)
  • OnoY et al.

    Associations of length of employment and working conditions with neck, shoulder and arm pain among nursery school teachers

    Industrial Health

    (2002)
  • PalmerKT et al.

    Use of keyboards and symptoms in the neck and arm: evidence from a national survey

    Occupational Med

    (2001)
  • PalmerKT et al.

    Prevalence and occupational associations of neck pain in the British population

    Scandinavian J of Work, Environ & Health

    (2001)
  • TrinkoffAM et al.

    Musculoskeletal problems of the neck, shoulder, back and functional consequences in nurses

    Am J Ind Med

    (2002)
  • TrinkoffAM et al.

    Workplace prevention and musculoskeletal injuries in nurses

    J of Nursing Administration

    (2003)
  • CassouB et al.

    Chronic neck and shoulder pain, age, working conditions: longitudinal results from a large random sample in France

    Occupational & Environ Med

    (2002)
  • Serratos-PerezJN et al.

    Musculoskeletal disorders among male sewing machine operators in shoemaking

    Ergonomics

    (1993)
  • AndersonR

    The back pain of bus drivers. Prevalence in an urban area of California

    Spine

    (1992)
  • EriksenW et al.

    Job characteristics as predictors of neck pain. A 4-year prospective study

    J Occup Environ Med

    (1999)
  • Cited by (172)

    • Differences in upper body posture between individuals with and without chronic idiopathic neck pain during computerised device use: A 3D motion analysis study

      2022, Gait and Posture
      Citation Excerpt :

      Neutral upper trunk posture (sagittal plane between −5° and 0° relative to an imaginary vertical axis) has shown the lowest posterior muscle activation and improved centre of balance [60]. Upper body posture flexed beyond 5° combined with sedentary behaviour is associated with an increased risk of lower back pain and the onset of neck MSD [61] from increased demands on upper body muscular structures and joints from the effects of gravity [62]. Conversely, a more extended thoracic spine combined with head/neck flexion reduces posterior cervical muscle loading and development of pain or discomfort [63].

    View all citing articles on Scopus

    The manuscript submitted does not contain information about medical device(s)/drug(s).

    No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

    Reprinted from Côté et al. 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. Spine 2008;33:S60-S74. Reprinted with permission from Lippincott Williams & Wilkins.

    View full text