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The prevalence of neck pain in the world population: a systematic critical review of the literature

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Abstract

The objective of this study was to determine the prevalence of neck pain (NP) in the world population and to identify areas of methodological variation between studies. A systematic search was conducted in five databases (MEDLINE, EMBASE, CINAHL, OSH-ROM, and PsycINFO), followed by a screening of reference lists of relevant papers. Included papers were extracted for information and each paper was given a quality score. Mean prevalence estimates were calculated for six prevalence periods (point, week, month, 6 months, year, and lifetime), and considered separately for age, gender, quality score, response rate, sample size, anatomical definition, geography, and publication year. Fifty-six papers were included. The six most commonly reported types of prevalence were point, week, month, 6 months, year, and lifetime. Except for lifetime prevalence, women reported more NP than men. For 1-year prevalence, Scandinavian countries reported more NP than the rest of Europe and Asia. Prevalence estimates were not affected by age, quality score, sample size, response rate, and different anatomical definitions of NP. NP is a common symptom in the population. As expected, the prevalence increases with longer prevalence periods and generally women have more NP than men. At least for 1-year prevalence Scandinavian countries report higher mean estimates than the rest of Europe and Asia. The quality of studies varies greatly but is not correlated with the prevalence estimates. Design varies considerably and standardisation is needed in future studies.

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References

  1. Andersson HI, Ejlertsson G, Leden I, Rosenberg C (1993) Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localization. Clin J Pain 9:174–182

    CAS  PubMed  Google Scholar 

  2. Aoyagi K, Ross PD, Huang C, Wasnich RD, Hayashi T, Takemoto T (1999) Prevalence of joint pain is higher among women in rural Japan than urban Japanese-American women in Hawaii. Ann Rheum Dis 58:315–319

    CAS  PubMed  Google Scholar 

  3. Ariëns GAM, Borghouts JAJ, Koes BW (1999) Neck pain. In: Crombie IK, Croft PR, Linton SJ, LeResche L, von Korff M (eds) Epidemiology of pain. IASP Press, Seattle, pp 235–256

    Google Scholar 

  4. Badley EM, Tennant A (1992) Changing profile of joint disorders with age: findings from a postal survey of the population of Calderdale, West Yorkshire, United Kingdom. Ann Rheum Dis 51:366–371

    CAS  PubMed  Google Scholar 

  5. Bassols A, Bosch F, Banos JE (2002) How does the general population treat their pain? A survey in Catalonia, Spain. J Pain Symptom Manage 23:318–328

    PubMed  Google Scholar 

  6. Bassols A, Bosch F, Campillo M, Canellas M, Banos JE (1999) An epidemiological comparison of pain complaints in the general population of Catalonia (Spain). Pain 83:9–16

    CAS  PubMed  Google Scholar 

  7. Bergenudd H, Nilsson B (1994) The prevalence of locomotor complaints in middle age and their relationship to health and socioeconomic factors. Clin Orthop 1(308):264–270

    Google Scholar 

  8. Bergman S, Herrstrom P, Hogstrom K, Petersson IF, Svensson B, Jacobsson LT (2001) Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study. J Rheumatol 28:1369–1377

    CAS  PubMed  Google Scholar 

  9. Birse TM, Lander J (1998) Prevalence of chronic pain. Can J Public Health 89:129–131

    CAS  PubMed  Google Scholar 

  10. Borghouts JA, Koes BW, Vondeling H, Bouter LM (1999) Cost-of-illness of neck pain in The Netherlands in 1996. Pain 80:629–636

    CAS  PubMed  Google Scholar 

  11. Bovim G, Schrader H, Sand T (1994) Neck pain in the general population. Spine 19:1307–1309

    CAS  PubMed  Google Scholar 

  12. Brattberg G, Thorslund M, Wikman A (1989) The prevalence of pain in a general population. The results of a postal survey in a county of Sweden. Pain 37:215–222

    CAS  PubMed  Google Scholar 

  13. Bredkjaer SR (1991) Musculoskeletal disease in Denmark. The Danish health and morbidity survey 1986–87. Acta Orthop Scand Suppl 241:10–12

    CAS  PubMed  Google Scholar 

  14. Brochet B, Michel P, Barberger-Gateau P, Dartigues JF (1998) Population-based study of pain in elderly people: a descriptive survey. Age Ageing 27:279–284

    Google Scholar 

  15. Cardiel MH, Rojas-Serrano J (2002) Community based study to estimate prevalence, burden of illness and help seeking behavior in rheumatic diseases in Mexico City. A COPCORD study. Clin Exp Rheumatol 20:617–624

    CAS  PubMed  Google Scholar 

  16. Catala E, Reig E, Artes M, Aliaga L, Lopez JS, Segu JL (2002) Prevalence of pain in the Spanish population: telephone survey in 5000 homes. Eur J Pain 6:133–140

    CAS  PubMed  Google Scholar 

  17. Chaiamnuay P, Darmawan J, Muirden KD, Assawatanabodee P (1998) Epidemiology of rheumatic disease in rural Thailand: a WHO-ILAR COPCORD study. J Rheumatol 25:1382–1387

    CAS  PubMed  Google Scholar 

  18. Chopra A, Saluja M, Patil J, Tandale HS (2002) Pain and disability, perceptions and beliefs of a rural Indian population: a WHO-ILAR COPCORD study. J Rheumatol 29:614–621

    PubMed  Google Scholar 

  19. Chrubasik S, Junck H, Zappe HA, Stutzke O (1998) A survey on pain complaints and health care utilization in a German population sample. Eur J Anaesthesiol 15:397–408

    CAS  PubMed  Google Scholar 

  20. Ciancaglini R, Testa M, Radaelli G (1999) Association of neck pain with symptoms of temporomandibular dysfunction in the general adult population. Scand J Rehabil Med 31:17–22

    CAS  PubMed  Google Scholar 

  21. Cote P, Cassidy JD, Carroll L (1998) The Saskatchewan health and back pain survey. The prevalence of neck pain and related disability in Saskatchewan adults. Spine 23:1689–1698

    CAS  PubMed  Google Scholar 

  22. Cote P, Cassidy JD, Carroll L (2001) The treatment of neck and low back pain: who seeks care? who goes where? Med Care 39:956–967

    CAS  PubMed  Google Scholar 

  23. Croft PR, Lewis M, Papageorgiou AC, Thomas E, Jayson MI, Macfarlane GJ, Silman AJ (2001) Risk factors for neck pain: a longitudinal study in the general population. Pain 93:317–325

    CAS  PubMed  Google Scholar 

  24. Crook J, Rideout E, Browne G (1984) The prevalence of pain complaints in a general population. Pain 18:299–314

    CAS  PubMed  Google Scholar 

  25. Daffner SD, Hilibrand AS, Hanscom BS, Brislin BT, Vaccaro AR, Albert TJ (2003) Impact of neck and arm pain on mean health status. Spine 28:2030–2035

    PubMed  Google Scholar 

  26. Eriksen HR, Svendsrod R, Ursin G, Ursin H (1998) Prevalence of subjective health complaints in the Nordic European countries in 1993. Eur J Public Health 8:294–298

    Google Scholar 

  27. Feldman DE, Shrier I, Rossignol M, Abenhaim L (2002) Risk factors for the development of neck and upper limb pain in adolescents. Spine 27:523–528

    Google Scholar 

  28. Fredriksson K, Alfredsson L, Koster M, Thorbjornsson CB, Toomingas A, Torgen M, Kilbom A (1999) Risk factors for neck and upper limb disorders: results from 24 years of follow up. Occup Environ Med 56:59–66

    CAS  PubMed  Google Scholar 

  29. Garcia FJB, Hernandez-Mejia R, Martin-Lascuevas P, Fernandez-Santana J, Cueto-Espinar A (1994) Epidemiology of musculoskeletal complaints and use of health services in Asturias, Spain. Scand J Rheumatol 23:137–141

    PubMed  Google Scholar 

  30. Gordon SJ, Trott P, Grimmer KA (2002) Waking cervical pain and stiffness, headache, scapular or arm pain: gender and age effects. Aust J Physiother 48:9–15

    PubMed  Google Scholar 

  31. Hagen K, Einarsen C, Zwart JA, Svebak S, Bovim G (2002) The co-occurrence of headache and musculoskeletal symptoms amongst 51,050 adults in Norway. Eur J Neurol 9:527–533

    CAS  PubMed  Google Scholar 

  32. Hagen KB, Kvien TK, Bjorndal A (1997) Musculoskeletal pain and quality of life in patients with noninflammatory joint pain compared to rheumatoid arthritis: a population survey. J Rheumatol 24:1703–1709

    CAS  PubMed  Google Scholar 

  33. Hakala P, Rimpela A, Salminen JJ, Virtanen SM, Rimpela M (2002) Back, neck, and shoulder pain in Finnish adolescents: national cross sectional surveys. BMJ 325:743

    PubMed  Google Scholar 

  34. Holmen TL, Barrett-Connor E, Holmen J, Bjermer L (2000) Health problems in teenage daily smokers versus nonsmokers, Norway, 1995–1997: the Nord-Trondelag health study. Am J Epidemiol 151:148–155

    CAS  PubMed  Google Scholar 

  35. Isacsson A, Hanson BS, Ranstam J, Rastam L, Isacsson SO (1995) Social network, social support and the prevalence of neck and low back pain after retirement. A population study of men born in 1914 in Malmo, Sweden. Scand J Soc Med 23:17–22

    CAS  PubMed  Google Scholar 

  36. Jacobsson L, Lindgarde F, Manthorpe R (1989) The commonest rheumatic complaints of over six weeks’ duration in a twelve-month period in a defined Swedish population. Prevalences and relationships. Scand J Rheumatol 18:353–360

    CAS  PubMed  Google Scholar 

  37. Lacey RJ, Lewis M, Sim J (2003) Presentation of pain drawings in questionnaire surveys: influence on prevalence of neck and upper limb pain in the community. Pain 105:293–301

    PubMed  Google Scholar 

  38. Lau EM, Sham A, Wong KC (1996) The prevalence of and risk factors for neck pain in Hong Kong Chinese. J Public Health Med 18:396–399

    CAS  PubMed  Google Scholar 

  39. Leboeuf-Yde C, Lauritsen JM (1995) The prevalence of low back pain in the literature. A structured review of 26 Nordic studies from 1954 to 1993. Spine 20:2112–2118

    CAS  PubMed  Google Scholar 

  40. LeResche L (1999) Gender considerations in the epidemiology of chronic pain. In: Crombie IK, Croft PR, Linton SJ, LeResche L, von Korff M (eds) Epidemiology of pain. IASP Press, Seattle, pp 43–52

    Google Scholar 

  41. Linton SJ, Hellsing AL, Hallden K (1998) A population-based study of spinal pain among 35–45-year-old individuals. Prevalence, sick leave, and health care use. Spine 23:1457–1463

    CAS  PubMed  Google Scholar 

  42. Linton SJ, Ryberg M (2000) Do epidemiological results replicate? The prevalence and health-economic consequences of neck and back pain in the general population. Eur J Pain 4:347–354

    CAS  PubMed  Google Scholar 

  43. Lock C, Allgar V, Jones K, Marples G, Chandler C, Dawson P (1999) Prevalence of back, neck and shoulder problems in the inner city: implications for the provision of physiotherapy services in primary healthcare. Physiother Res Int 4:161–169

    CAS  PubMed  Google Scholar 

  44. Loney PL, Chambers LW, Bennett KJ, Roberts JG, Stratford PW (1998) Critical appraisal of the health research literature: prevalence or incidence of a health problem. Chronic Dis Can 19:170–176

    CAS  PubMed  Google Scholar 

  45. Loney PL, Stratford PW (1999) The prevalence of low back pain in adults: a methodological review of the literature. Phys Ther 79:384–396

    CAS  PubMed  Google Scholar 

  46. Makela M, Heliovaara M, Sievers K, Impivaara O, Knekt P, Aromaa A (1991) Prevalence, determinants, and consequences of chronic neck pain in Finland. Am J Epidemiol 134:1356–1367

    CAS  PubMed  Google Scholar 

  47. Manahan L, Caragay R, Muirden KD, Allander E, Valkenburg HA, Wigley RD (1985) Rheumatic pain in a Philippine village. A WHO-ILAR COPCORD study. Rheumatol Int 5:149–153

    CAS  PubMed  Google Scholar 

  48. March LM, Brnabic AJ, Skinner JC, Schwarz JM, Finnegan T, Druce J, Brooks PM (1998) Musculoskeletal disability among elderly people in the community. Med J Aust 168:439–442

    CAS  PubMed  Google Scholar 

  49. Marx RG, Hogg-Johnson S, Hudak P, Beaton D, Shields S, Bombardier C, Wright JG (2001) A comparison of patients’ responses about their disability with and without attribution to their affected area. J Clin Epidemiol 54:580–586

    CAS  PubMed  Google Scholar 

  50. McColl E, Jacoby A, Thomas L, Soutter J, Bamford C, Steen N, Thomas R, Harvey E, Garratt A, Bond J (2001) Design and use of questionnaires: a review of best practice applicable to surveys of health service staff and patients. Health Technol Assess 5:1–256

    CAS  Google Scholar 

  51. Mikkelsson M, Salminen JJ, Kautiainen H (1997) Non-specific musculoskeletal pain in preadolescents. Prevalence and 1-year persistence. Pain 73:29–35

    CAS  PubMed  Google Scholar 

  52. Niemi SM, Levoska S, Rekola KE, Keinanen-Kiukaanniemi SM (1997) Neck and shoulder symptoms of high school students and associated psychosocial factors. J Adolesc Health 20:238–242

    CAS  PubMed  Google Scholar 

  53. Palmer K, Smith G, Kellingray S, Cooper C (1999) Repeatability and validity of an upper limb and neck discomfort questionnaire: the utility of the standardized Nordic questionnaire. Occup Med (Lond) 49:171–175

    CAS  Google Scholar 

  54. Palmer KT, Walker-Bone K, Griffin MJ, Syddall H, Pannett B, Coggon D, Cooper C (2001) Prevalence and occupational associations of neck pain in the British population. Scand J Work Environ Health 27:49–56

    CAS  PubMed  Google Scholar 

  55. Rajala U, Keinanen-Kiukaanniemi S, Uusimaki A, Kivela SL (1995) Musculoskeletal pains and depression in a middle-aged Finnish population. Pain 61:451–457

    CAS  PubMed  Google Scholar 

  56. Rauhala K, Oikarinen KS, Jarvelin MR, Raustia AM (2000) Facial pain and temporomandibular disorders: an epidemiological study of the Northern Finland 1966 birth cohort. Cranio 18:40–46

    CAS  PubMed  Google Scholar 

  57. Reyes-Llerena GA, Guibert-Toledano M, Hernandez-Martinez AA, Gonzalez-Otero ZA, Alcocer-Varela J, Cardiel MH (2000) Prevalence of musculoskeletal complaints and disability in Cuba. A community-based study using the COPCORD core questionnaire. Clin Exp Rheumatol 18:739–742

    CAS  PubMed  Google Scholar 

  58. Spoor P, Airey M, Bennett C, Greensill J, Williams R (1996) Use of the capture-recapture technique to evaluate the completeness of systematic literature searches. BMJ 313:342–343

    CAS  PubMed  Google Scholar 

  59. Stendig-Lindberg G (1998) Prevalence of musculoskeletal pain and its socio-demographic correlates in an urban Israeli population sample. Eur J Phys Med Rehabil 8:77–80

    Google Scholar 

  60. Takala J, Sievers K, Klaukka T (1982) Rheumatic symptoms in the middle-aged population in southwestern Finland. Scand J Rheumatol Suppl 47:15–29

    CAS  PubMed  Google Scholar 

  61. Toomingas A (1999) Characteristics of pain drawings in the neck–shoulder region among the working population. Int Arch Occup Environ Health 72:98–106

    CAS  PubMed  Google Scholar 

  62. Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, Simmons A, Williams G (1998) Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis 57:649–655

    CAS  PubMed  Google Scholar 

  63. van der Donk J, Schouten JS, Passchier J, van Romunde LK, Valkenburg HA (1991) The associations of neck pain with radiological abnormalities of the cervical spine and personality traits in a general population. J Rheumatol 18:1884–1889

    PubMed  Google Scholar 

  64. Viikari-Juntura E, Vuori J, Silverstein BA, Kalimo R, Kuosma E, Videman T (1991) A life-long prospective study on the role of psychosocial factors in neck–shoulder and low-back pain. Spine 16:1056–1061

    CAS  PubMed  Google Scholar 

  65. Vikat A, Rimpela M, Salminen JJ, Rimpela A, Savolainen A, Virtanen SM (2000) Neck or shoulder pain and low back pain in Finnish adolescents. Scand J Public Health 28:164–173

    CAS  PubMed  Google Scholar 

  66. Wedderkopp N, Leboeuf-Yde C, Andersen LB, Froberg K, Hansen HS (2001) Back pain reporting pattern in a Danish population-based sample of children and adolescents. Spine 26:1879–1883

    CAS  PubMed  Google Scholar 

  67. Westerling D, Jonsson BG (1980) Pain from the neck-shoulder region and sick leave. Scand J Soc Med 8:131–136

    CAS  PubMed  Google Scholar 

  68. Wigley RD, Prior IA, Salmond C, Stanley D, Pinfold B (1987) Rheumatic complaints in Tokelau. I. Migrants resident in New Zealand. The Tokelau Island migrant study. Rheumatol Int 7:53–59

    CAS  PubMed  Google Scholar 

  69. Wigley RD, Prior IA, Salmond C, Stanley D, Pinfold B (1987) Rheumatic complaints in Tokelau. II. A comparison of migrants in New Zealand and non-migrants. The Tokelau Island migrant study. Rheumatol Int 7:61–65

    CAS  PubMed  Google Scholar 

  70. Wigley RD, Zhang NZ, Zeng QY, Shi CS, Hu DW, Couchman K, Duff IF, Bennett PH (1994) Rheumatic diseases in China: ILAR-China study comparing the prevalence of rheumatic symptoms in northern and southern rural populations. J Rheumatol 21:1484–1490

    CAS  PubMed  Google Scholar 

  71. Woo J, Ho SC, Lau J, Leung PC (1994) Musculoskeletal complaints and associated consequences in elderly Chinese aged 70 years and over. J Rheumatol 21:1927–1931

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark

    René Fejer & Jan Hartvigsen

  2. Institute of Public Health, Epidemiology, The Danish Twin Registry, University of Southern Denmark, Odense, Denmark

    René Fejer & Kirsten Ohm Kyvik

  3. Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark

    Jan Hartvigsen

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Fejer, R., Kyvik, K.O. & Hartvigsen, J. The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J 15, 834–848 (2006). https://doi.org/10.1007/s00586-004-0864-4

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