Neck Pain Prognosis

Neck pain is one of the most common musculoskeletal disorders, with an estimated 1-year prevalence of 31.4% to 35.6% of adults in the general population. The course of neck pain is characterized by exacerbations and remissions and only a small part of the patients experience complete resolution of their symptoms within 1 year.5

A substantial proportion of the neck pain patients will thus develop chronic neck pain. The definition of chronic pain differs between studies, in terms of either 3 or 6 months duration of complaints. Nevertheless, the estimates of their 1-year prevalence in the general population are similar: 8.7% to 17.8% for the 3-months definition, and 8% to 13.8% for the 6-months definition.

An important question is whether we can identify patients at risk of persistent complaints at the first consultation with the physician, based on their personal characteristics? This information could be helpful for a physician to gain insight into the prognosis of an individual patient with neck pain, and would aid in informing patients more accurately about their expected prognosis. Furthermore, this would aid researchers in selecting patients at high risk in studies on prevention of chronic neck pain.

Some studies have been conducted based on characteristics associated with persistence of neck complaints in the general population. Characteristics identified as a predictor in more than 1 study were age, duration of complaints, previous episode of neck pain, pain intensity, physical functioning, and accompanying low back pain. However, none of the studies constructed a prediction model that quantifies prognosis.

This form is an attempt to duplicate the results of a study which developed and externally validated a prediction rule that estimates the probability of complaints persisting for at least 6 months in patients consulting their physician for nonspecific neck pain.

The results from the example given in the appendix of the study differed by 1 point in the form, however, the results were the same percentages for prognosis. Therefore, this form gives an approximation of prognosis based on the study referenced below.

NOTE: This form estimates the probability of complaints persisting for at least 6 months in patients consulting their physician for nonspecific neck pain. Please answer each section by checking the ONE CHOICE that most most closely describes your condition right now.

After answering the items click on the 'Prognosis' button. A new window will open with the Percentage Score or Range of Percentages of your neck pain persisting for at least 6 months.

This form is based on: Prognosis of Patients With Nonspecific Neck Pain Development and External Validation of a Prediction Rule for Persistence of Complaints. SPINE Volume 35, Number 17, pp E827–E835 2010, Jasper M. Schellingerhout, MD, Martijn W. Heymans, PhD, Arianne P. Verhagen, PhD, Martyn Lewis, PhD, Henrica C. W. de Vet, PhD, and Bart W. Koes, PhD.

Total Score Probability that neck complaints will still be present at 6 months after the first consultation:

< 10 = 0%–20%

10–34 = 20%–40%

35–54 = 40%–60%

55–79 = 60%–80%

> 79 = 80%–100%

According to the study, "The score chart predicts significantly better for every patient if he/she will develop persistent complaints, than estimates for the overall population. This makes the score chart informative for patients and physicians and facilitates future research in patients with high risk of developing chronic neck pain."

This is considered a work in progress and updates should be expected pending feedback.