Risk Factors For Neck Pain

An interesting study in European Spine Journal. 2007 May; 16(5): 679-686. sheds some light on risk factors for neck pain. By observing the results, we can see some trends for those of us who are at risk and take some measures to help prevent neck pain or use as a guide for intervention.

A total of 45.5% of the population studied reported neck pain in the past 12 months, of which 18.1% complaint of continuous neck pain. A total of 64.3% of the patients reported that there was a relation between their current job and the neck complaints. A total of 56.2% even mentioned that their complaints started during the current job. A total of 10.2% reported sick leave due to neck complaints. The work place and equipment were adapted in 24% of the patients due to neck pain. Work time was changed due to the same reason.

It should be noted that marital status, formal education, cigarette smoking and sleeping hours were not linked to the likelihood of subsequent neck pain.

Work related physical factors for neck pain:

Analyses of the association between neck pain and work related physical factors, revealed that neck pain was significantly associated with often holding the neck in a forward bent posture for a prolonged time, various short periods of movements with the neck, often working in the same position for a prolonged time, often making the same movements per minute, often sitting for a prolonged time, dry air and temperature fluctuation, and computer working time.

Work related psychosocial factors for neck pain:

The following work related psychosocial factors showed a positive association with neck pain: mental tiredness at the end of the workday, shortage of personnel, not being rested after break; no variation at work, doing the same work all day, getting annoyed about others.

Women have an almost two-fold risk compared with men. Persons older than 30 years have more than two and one half times more chance of having neck pain than younger individuals. Being physically active decreases the likelihood of having neck pain.

Often holding the neck in a forward bent posture for a prolonged time, often sitting for a prolonged time and often making the same movements per minute are risk factors for neck pain.

The risk of neck pain is about two-fold for those experiencing mental tiredness at the end of the workday in comparison to those who do not experience tiredness. Shortage of personnel increases the risk of neck pain.

Individual factors for neck pain

The prevalence of neck pain is higher among women than men. This gender pattern is seen in most types of body pain and several sociological, cultural and physical differences have been proposed as explanations, but these hypotheses have not been shown to be satisfactory. Smaller stature and lower strength of the shoulder muscles have been suggested to partly explain the sex difference. Concerning computer work in particular, gender differences have been found, for example, in the use of a computer mouse. Women are working with higher relative musculoskeletal load, for instance, applying higher forces to the mouse and using greater rang of motion, than are men. Additionally, women are known to report more symptoms than men.

An association was found between age and the prevalence of neck pain. The risk of neck pain increased until the age of 50 and decreased slightly thereafter. The increase with age can be understood by increasing degenerative disc disease of the neck with age. The decrease of neck pain in the oldest age group is more difficult to explain; it may be that chronic diseases and other ailments may gain the upper hand or the degenerative process tends to stabilize with fusion of cervical spine structures.

Being physically active decreases the likelihood of having neck pain. Employees who exercised less frequently demonstrated a higher risk of neck pain. This may have some clinical implications: stimulation of leisure time physical activity may constitute one of the means of reducing musculoskeletal morbidity in the working population, in particular in sedentary workers.

Work related physical factors for neck pain

Often holding the neck in a forward posture for a prolonged time, and working in the same position for a prolonged time were significantly associated with neck pain. There is a positive relation between forward bending of the neck (neck flexion) and neck pain, suggesting an increased risk of neck pain for those who spent a high percentage of the working time with the neck at a minimum of 20 degrees of flexion.

Often making the same movements per minute was significantly associated with neck pain. When performing work with the hands and fingers, the muscles in the neck and shoulder region must usually act as stabilizers. Static contraction of the trapezius and other shoulder muscles is needed to keep the arms at right angles, a necessary posture when using the keyboard. This contraction is accentuated when there is also rotation or bending of the neck when the computer screen is placed to the side of the worker, not in front which is the recommended position. Pain may also be attributed to changing muscle patterns reflecting more the personal habitual movements and postures rather than the influence of their workstations alone.

A significant positive relation was found between sitting posture and neck pain. Previous studies found that workers who sat for more than 95% of the working time the risk of neck pain was twice as high as for worker who hardly ever worked in a sitting position. The risk for neck pain increases with the time spent working in a sitting position, suggesting a clear relation between sitting posture and neck pain. Previous studies reported a relation between sitting for more than 5 hours a day and self reported neck pain. Remaining seated for long periods, usually accompanied by curvature of the spine, increases pressure on vertebral discs, ligaments, and muscles.

Some climatological conditions (dry air and temperature fluctuation) seem to be a significant predictor for neck pain. Studies found a positive association between the different aspects of physical work environment and neck pain. It has been demonstrated that inadequate thermal comfort was associated with neck symptoms. There is a possibility that subjects with neck pain may have a different perception of their work environment.

Analyses of the association between neck pain and work related physical factors, revealed that neck pain was associated with computer working time.

Work related psychosocial factors for neck pain

Different work related psychosocial factors showed a positive association with neck pain, but only mental tiredness at the end of the day and shortage of personnel were independently related. Reporting shortage of personnel may be an indirect reflection of work (over) load. There is consistent evidence that stress is associated with neck pain.

The protective effect of rest breaks was also reported in other studies. Breaks allow a reduction in computer exposure, but more especially permit muscle relaxation.

The study results suggest that effective intervention strategies aiming at reducing the occurrence of neck pain most likely have to take into account both ergonomic improvements and cognitive behavioral aspects. Based on the results of this study, intervention should be applied to reduce computer exposure and also toward improving ergonomic conditions. Dynamic sitting chairs will lead to more variation in posture and comfort. The use of document holders and correct placement of the screen will reduce the neck load. Compulsory rest breaks could be introduced to reduce computer use. See more on neck pain and headache relief and computers.

Another more recent study in the European Spine Journal 2011 Dec 19, found that workplace bullying, sleeping problems, and high body mass index in women, and work-related emotional exhaustion in men were risk factors for chronic neck pain. In both genders, previous acute neck pain and chronic lower back pain were risk factors for chronic neck pain.