Abstract
Background context
Current evidence suggests that neck pain is negatively associated with health-related
quality of life (HRQoL). However, these studies are cross-sectional and do not inform
the association between neck pain and future HRQoL.
Purpose
The purpose of this study was to investigate the association between increasing grades
of neck pain severity and HRQoL 6 months later. In addition, this longitudinal study
examines the crude association between the course of neck pain and HRQoL.
Study design
This is a population-based cohort study.
Patient sample
Eleven hundred randomly sampled Saskatchewan adults were included.
Outcome measures
Outcome measures were the mental component summary (MCS) and physical component summary
(PCS) of the Short-Form-36 (SF-36) questionnaire.
Methods
We formed a cohort of 1,100 randomly sampled Saskatchewan adults in September 1995.
We used the Chronic Pain Questionnaire to measure neck pain and its related disability.
The SF-36 questionnaire was used to measure physical and mental HRQoL 6 months later.
Multivariable linear regression was used to measure the association between graded
neck pain and HRQoL while controlling for confounding. Analysis of variance and t
tests were used to measure the crude association among four possible courses of neck
pain and HRQoL at 6 months. The neck pain trajectories over 6 months were no or mild
neck pain, improving neck pain, worsening neck pain, and persistent neck pain. Finally,
analysis of variance was used to examine changes in baseline to 6-month PCS and MCS
scores among the four neck pain trajectory groups.
Results
The 6-month follow-up rate was 74.9%. We found an exposure-response relationship between
neck pain and physical HRQoL after adjusting for age, education, arthritis, low back
pain, and depressive symptomatology. Compared with participants without neck pain
at baseline, those with mild (β=−1.53, 95% confidence interval [CI]=–2.83, –0.24),
intense (β=−3.60, 95% CI=–5.76, –1.44), or disabling (β=−8.55, 95% CI=–11.68, –5.42)
neck pain had worse physical HRQoL 6 months later. We did not find an association
between neck pain and mental HRQoL. A worsening course of neck pain and persistent
neck pain were associated with worse physical HRQoL.
Conclusions
We found that neck pain was negatively associated with physical but not mental HRQoL.
Our analysis suggests that neck pain may be a contributor of future poor physical
HRQoL in the population. Raising awareness of the possible future impact of neck pain
on physical HRQoL is important for health-care providers and policy makers with respect
to the management of neck pain in populations.
Keywords
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Article info
Publication history
Published online: December 11, 2014
Accepted:
December 3,
2014
Received in revised form:
September 18,
2014
Received:
May 29,
2012
Footnotes
FDA device/drug status: Not applicable.
Author disclosures: PSN: Nothing to disclose. PC: Consulting: Financial Commission Services of Ontario (C, Paid directly to institution); Speaking and/or Teaching Arrangements: Societédes Experts an Evaluation Medico-Légale du Québec, NCMIC Insurance Company, Canadian Chiropractic Malpractice Association, Trillium Health Center Spine Institute; (A) Research support (Investigator Salary, Staff/Materials): Canadian Institutes of Health Research—Undergraduate Summer Studentship (B, Paid directly to institution); Grants: Canadian Institutes of Health Research (F, Paid directly to institution), Ontario Workplace Safety and Insurance Board (D, Paid directly to institution), Aviva Canada (I, Paid directly to institution), Canadian Chiropractic Malpractice Association (F, Paid directly to institution), Ontario Neurotrauma Foundation (F, Paid directly to institution), WorkSafeBC (F, Paid directly to institution). VLK: Consulting: Consulting income from Institute for Work & Health (C); Speaking and/or Teaching Arrangements: Salary from Lakehead University for teaching and research; Grants: Canadian Institute of Health Research research grant (E, Paid directly to institution). MR: Nothing to disclose. LJC: Grant: Chiropractor's Association of Saskatchewan (partial funding for original data collection) (C, Paid directly to institution); Speaking and/or Teaching Arrangements: Invited speaker, Pierre Forcier Fourth Annual Meeting (A); Grants: WorkSafeBC (E, Paid directly to institution), EndMS Research and Training Network (C, Paid directly to institution), WCB Manitoba (F, Paid directly to institution), WCB Alberta (D, Paid directly to institution), AHFMR (D, Paid directly to institution). JDC: Grant: Chiropractors' Association of Saskatchewan (C, Paid directly to institution).
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