Skip to main content
Top
Published in: Chiropractic & Manual Therapies 1/2016

Open Access 01-12-2016 | Research

Importance of psychological factors for the recovery from a first episode of acute non-specific neck pain - a longitudinal observational study

Authors: Brigitte Wirth, B. Kim Humphreys, Cynthia Peterson

Published in: Chiropractic & Manual Therapies | Issue 1/2016

Login to get access

Abstract

Background

The influence of psychological factors on acute neck pain is sparsely studied. In a secondary analysis of prospectively collected data, this study investigated how several psychological factors develop in the first three months of acute neck pain and how these factors influence self-perceived recovery.

Methods

Patients were recruited in various chiropractic practices throughout Switzerland between 2010 and 2014. The follow-up telephone interviews were conducted for all patients by research assistants in the coordinating university hospital following a standardized procedure. The population of this study consisted of 103 patients (68 female; mean age = 38.3 ± 13.8 years) with a first episode of acute (<4 weeks) neck pain. Prior to the first treatment, the patients filled in the Bournemouth Questionnaire (BQ). One week and 1 and 3 months later, they completed the BQ again along with the Patient Global Impression of Change (PGIC). The temporal development (repeated measure ANOVA) of the BQ questions 4 (anxiety), 5 (depression), 6 (fear-avoidance) and 7 (pain locus of control) as well as the influence of these scores on the PGIC were investigated (binary logistic regression analyses, receiver operating curves (ROC)).

Results

All psychological parameters showed significant reduction within the first month. The parameter ‘anxiety’ was associated with outcome at 1 and 3 months (p = 0.013, R2 = 0.40 and p = 0.039, R2 = 0.63, respectively). Baseline depression (p = 0.037, R2 = 0.21), but not baseline anxiety, was a predictor for poor outcome. A high reduction in anxiety within the first month was a significant predictor for favorable outcome after 1 month (p < 0.001; R2 = 0.57).

Conclusions

Psychological factors emerged from this study as relevant in the early phase of acute neck pain. Particularly persistent anxiety and depression at baseline might be risk factors for a transition to chronic pain that should be addressed in the early management of neck pain patients.
Literature
1.
go back to reference Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–96.CrossRefPubMed Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–96.CrossRefPubMed
2.
go back to reference Hoy DG, Protani M, De R, Buchbinder R. The epidemiology of neck pain. Best Pract Res Clin Rheumatol. 2010;24:783–92.CrossRefPubMed Hoy DG, Protani M, De R, Buchbinder R. The epidemiology of neck pain. Best Pract Res Clin Rheumatol. 2010;24:783–92.CrossRefPubMed
3.
go back to reference Cote P, Cassidy JD, Carroll LJ, Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 2004;112:267–73.CrossRefPubMed Cote P, Cassidy JD, Carroll LJ, Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 2004;112:267–73.CrossRefPubMed
4.
go back to reference Pool JJ, Ostelo RW, Knol D, Bouter LM, de Vet HC. Are psychological factors prognostic indicators of outcome in patients with sub-acute neck pain? Man Ther. 2010;15:111–6.CrossRefPubMed Pool JJ, Ostelo RW, Knol D, Bouter LM, de Vet HC. Are psychological factors prognostic indicators of outcome in patients with sub-acute neck pain? Man Ther. 2010;15:111–6.CrossRefPubMed
5.
go back to reference Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Do psychological states associate with pain and disability in chronic neck pain patients? J Back Musculoskelet Rehabil. 2015;28(4):797–802.CrossRefPubMed Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Do psychological states associate with pain and disability in chronic neck pain patients? J Back Musculoskelet Rehabil. 2015;28(4):797–802.CrossRefPubMed
6.
go back to reference Ailliet L, Rubinstein SM, Knol D, Van Tulder MW, De Vet HC. Somatization is associated with worse outcome in a chiropractic patient population with neck pain and low back pain. Man Ther. 2016;21:170–6.CrossRefPubMed Ailliet L, Rubinstein SM, Knol D, Van Tulder MW, De Vet HC. Somatization is associated with worse outcome in a chiropractic patient population with neck pain and low back pain. Man Ther. 2016;21:170–6.CrossRefPubMed
7.
8.
go back to reference Hurwitz EL, Goldstein MS, Morgenstern H, Chiang LM. The impact of psychosocial factors on neck pain and disability outcomes among primary care patients: results from the UCLA Neck Pain Study. Disabil Rehabil. 2006;28:1319–29.CrossRefPubMed Hurwitz EL, Goldstein MS, Morgenstern H, Chiang LM. The impact of psychosocial factors on neck pain and disability outcomes among primary care patients: results from the UCLA Neck Pain Study. Disabil Rehabil. 2006;28:1319–29.CrossRefPubMed
9.
go back to reference Walton DM, Carroll LJ, Kasch H, Sterling M, Verhagen AP, Macdermid JC, et al. An overview of systematic reviews on prognostic factors in neck pain: results from the International Collaboration on Neck Pain (ICON) Project. Open Orthop J. 2013;7:494–505.CrossRefPubMedPubMedCentral Walton DM, Carroll LJ, Kasch H, Sterling M, Verhagen AP, Macdermid JC, et al. An overview of systematic reviews on prognostic factors in neck pain: results from the International Collaboration on Neck Pain (ICON) Project. Open Orthop J. 2013;7:494–505.CrossRefPubMedPubMedCentral
10.
go back to reference Carroll LJ, Hogg-Johnson S, van der Velde G, Haldeman S, Holm LW, Carragee EJ, 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. J Manipulative Physiol Ther. 2009;32:S87–96.CrossRefPubMed Carroll LJ, Hogg-Johnson S, van der Velde G, Haldeman S, Holm LW, Carragee EJ, 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. J Manipulative Physiol Ther. 2009;32:S87–96.CrossRefPubMed
11.
go back to reference McLean S, May S, Klaber Moffett J, MacFie Sharp D. E G. Prognostic factors for progressive non-specific neck pain: a systematic review. Phys Ther Rev. 2007;12:207–20.CrossRef McLean S, May S, Klaber Moffett J, MacFie Sharp D. E G. Prognostic factors for progressive non-specific neck pain: a systematic review. Phys Ther Rev. 2007;12:207–20.CrossRef
12.
go back to reference Bot SD, van der Waal JM, Terwee CB, van der Windt DA, Scholten RJ, Bouter LM, et al. Predictors of outcome in neck and shoulder symptoms: a cohort study in general practice. Spine. 2005;30:E459–70.CrossRefPubMed Bot SD, van der Waal JM, Terwee CB, van der Windt DA, Scholten RJ, Bouter LM, et al. Predictors of outcome in neck and shoulder symptoms: a cohort study in general practice. Spine. 2005;30:E459–70.CrossRefPubMed
13.
go back to reference Hill J, Lewis M, Papageorgiou AC, Dziedzic K, Croft P. Predicting persistent neck pain: a 1-year follow-up of a population cohort. Spine. 2004;29:1648–54.CrossRefPubMed Hill J, Lewis M, Papageorgiou AC, Dziedzic K, Croft P. Predicting persistent neck pain: a 1-year follow-up of a population cohort. Spine. 2004;29:1648–54.CrossRefPubMed
14.
go back to reference Walton DM, Macdermid JC, Giorgianni AA, Mascarenhas JC, West SC, Zammit CA. Risk factors for persistent problems following acute whiplash injury: update of a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2013;43:31–43.CrossRefPubMed Walton DM, Macdermid JC, Giorgianni AA, Mascarenhas JC, West SC, Zammit CA. Risk factors for persistent problems following acute whiplash injury: update of a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2013;43:31–43.CrossRefPubMed
15.
go back to reference Dworkin RH, Turk DC, Wyrwich KW, Beaton D, Cleeland CS, Farrar JT, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain. 2008;9:105–21.CrossRefPubMed Dworkin RH, Turk DC, Wyrwich KW, Beaton D, Cleeland CS, Farrar JT, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain. 2008;9:105–21.CrossRefPubMed
16.
go back to reference Fischer D, Stewart AL, Bloch DA, Lorig K, Laurent D, Holman H. Capturing the patient’s view of change as a clinical outcome measure. JAMA. 1999;282:1157–62.CrossRefPubMed Fischer D, Stewart AL, Bloch DA, Lorig K, Laurent D, Holman H. Capturing the patient’s view of change as a clinical outcome measure. JAMA. 1999;282:1157–62.CrossRefPubMed
17.
go back to reference Peterson C, Bolton J, Humphreys BK. Predictors of outcome in neck pain patients undergoing chiropractic care: comparison of acute and chronic patients. Chiropr Man Therap. 2012;20:27.CrossRefPubMedPubMedCentral Peterson C, Bolton J, Humphreys BK. Predictors of outcome in neck pain patients undergoing chiropractic care: comparison of acute and chronic patients. Chiropr Man Therap. 2012;20:27.CrossRefPubMedPubMedCentral
18.
go back to reference Bolton JE, Humphreys BK. The Bournemouth Questionnaire: a short-form comprehensive outcome measure. II. Psychometric properties in neck pain patients. J Manipulative Physiol Ther. 2002;25:141–8.CrossRefPubMed Bolton JE, Humphreys BK. The Bournemouth Questionnaire: a short-form comprehensive outcome measure. II. Psychometric properties in neck pain patients. J Manipulative Physiol Ther. 2002;25:141–8.CrossRefPubMed
19.
go back to reference Soklic M, Peterson C, Humphreys BK. Translation and validation of the German version of the Bournemouth questionnaire for neck pain. Chiropr Man Therap. 2012;20:2.CrossRefPubMedPubMedCentral Soklic M, Peterson C, Humphreys BK. Translation and validation of the German version of the Bournemouth questionnaire for neck pain. Chiropr Man Therap. 2012;20:2.CrossRefPubMedPubMedCentral
20.
go back to reference Bolton JE, Breen AC. The Bournemouth Questionnaire: a short-form comprehensive outcome measure. I. Psychometric properties in back pain patients. J Manipulative Physiol Ther. 1999;22:503–10.CrossRefPubMed Bolton JE, Breen AC. The Bournemouth Questionnaire: a short-form comprehensive outcome measure. I. Psychometric properties in back pain patients. J Manipulative Physiol Ther. 1999;22:503–10.CrossRefPubMed
21.
go back to reference Hurst H, Bolton J. Assessing the clinical significance of change scores recorded on subjective outcome measures. J Manipulative Physiol Ther. 2004;27:26–35.CrossRefPubMed Hurst H, Bolton J. Assessing the clinical significance of change scores recorded on subjective outcome measures. J Manipulative Physiol Ther. 2004;27:26–35.CrossRefPubMed
22.
go back to reference Williamson E, Williams MA, Gates S, Lamb SE. Risk factors for chronic disability in a cohort of patients with acute whiplash associated disorders seeking physiotherapy treatment for persisting symptoms. Physiotherapy. 2015;101:34–43.CrossRefPubMed Williamson E, Williams MA, Gates S, Lamb SE. Risk factors for chronic disability in a cohort of patients with acute whiplash associated disorders seeking physiotherapy treatment for persisting symptoms. Physiotherapy. 2015;101:34–43.CrossRefPubMed
23.
go back to reference Field A. Discovering statistics using SPSS. 3rd ed. London: SAGE Publications; 2009. Field A. Discovering statistics using SPSS. 3rd ed. London: SAGE Publications; 2009.
24.
go back to reference Michalski D, Zweynert U, Kuppers-Tiedt L, Hinz A. Physical complaints, emotional stress and locus of control in the course of orthopaedic rehabilitation. Rehabilitation. 2008;47:299–307.CrossRefPubMed Michalski D, Zweynert U, Kuppers-Tiedt L, Hinz A. Physical complaints, emotional stress and locus of control in the course of orthopaedic rehabilitation. Rehabilitation. 2008;47:299–307.CrossRefPubMed
25.
go back to reference Darlow B, Dean S, Perry M, Mathieson F, Baxter GD, Dowell A. Acute low back pain management in general practice: uncertainty and conflicting certainties. Fam Pract. 2014;31:723–32.CrossRefPubMed Darlow B, Dean S, Perry M, Mathieson F, Baxter GD, Dowell A. Acute low back pain management in general practice: uncertainty and conflicting certainties. Fam Pract. 2014;31:723–32.CrossRefPubMed
26.
go back to reference Henrotin Y, Moyse D, Bazin T, Cedraschi C, Duplan B, Duquesnoy B, et al. Study of the information delivery by general practitioners and rheumatologists to patients with acute low back pain. Eur Spine J. 2011;20:720–30.CrossRefPubMedPubMedCentral Henrotin Y, Moyse D, Bazin T, Cedraschi C, Duplan B, Duquesnoy B, et al. Study of the information delivery by general practitioners and rheumatologists to patients with acute low back pain. Eur Spine J. 2011;20:720–30.CrossRefPubMedPubMedCentral
27.
go back to reference Darlow B, Dean S, Perry M, Mathieson F, Baxter GD, Dowell A. Easy to harm, hard to heal: patient views about the back. Spine. 2015;40:842–50.CrossRefPubMed Darlow B, Dean S, Perry M, Mathieson F, Baxter GD, Dowell A. Easy to harm, hard to heal: patient views about the back. Spine. 2015;40:842–50.CrossRefPubMed
28.
go back to reference Klaber Moffett JA, Jackson DA, Richmond S, Hahn S, Coulton S, Farrin A, et al. Randomised trial of a brief physiotherapy intervention compared with usual physiotherapy for neck pain patients: outcomes and patients’ preference. BMJ. 2005;330:75.CrossRefPubMedPubMedCentral Klaber Moffett JA, Jackson DA, Richmond S, Hahn S, Coulton S, Farrin A, et al. Randomised trial of a brief physiotherapy intervention compared with usual physiotherapy for neck pain patients: outcomes and patients’ preference. BMJ. 2005;330:75.CrossRefPubMedPubMedCentral
29.
go back to reference Monticone M, Ambrosini E, Cedraschi C, Rocca B, Fiorentini R, Restelli M, et al. Cognitive-behavioral treatment for subacute and chronic neck pain: a cochrane review. Spine. 2015;40:1495–504.CrossRefPubMed Monticone M, Ambrosini E, Cedraschi C, Rocca B, Fiorentini R, Restelli M, et al. Cognitive-behavioral treatment for subacute and chronic neck pain: a cochrane review. Spine. 2015;40:1495–504.CrossRefPubMed
30.
go back to reference Schnitzer TJ, Ferraro A, Hunsche E, Kong SX. A comprehensive review of clinical trials on the efficacy and safety of drugs for the treatment of low back pain. J Pain Symptom Manage. 2004;28:72–95.CrossRefPubMed Schnitzer TJ, Ferraro A, Hunsche E, Kong SX. A comprehensive review of clinical trials on the efficacy and safety of drugs for the treatment of low back pain. J Pain Symptom Manage. 2004;28:72–95.CrossRefPubMed
31.
go back to reference Behrbalk E, Halpern P, Boszczyk BM, Parks RM, Chechik O, Rosen N, et al. Anxiolytic medication as an adjunct to morphine analgesia for acute low back pain management in the emergency department: a prospective randomized trial. Spine. 2014;39:17–22.CrossRefPubMed Behrbalk E, Halpern P, Boszczyk BM, Parks RM, Chechik O, Rosen N, et al. Anxiolytic medication as an adjunct to morphine analgesia for acute low back pain management in the emergency department: a prospective randomized trial. Spine. 2014;39:17–22.CrossRefPubMed
32.
go back to reference Scott W, McCracken LM. Patients’ impression of change following treatment for chronic pain: global, specific, a single dimension, or many? J Pain. 2015;16(6):518–26.CrossRefPubMed Scott W, McCracken LM. Patients’ impression of change following treatment for chronic pain: global, specific, a single dimension, or many? J Pain. 2015;16(6):518–26.CrossRefPubMed
33.
go back to reference Swanenburg J, Gruber C, Brunner F, Wirth B. Patients’ and therapists’ perception of change following physiotherapy in an orthopedic hospital’s outpatient clinic. Physiother Theory Pract. 2015;31:293–8.CrossRefPubMed Swanenburg J, Gruber C, Brunner F, Wirth B. Patients’ and therapists’ perception of change following physiotherapy in an orthopedic hospital’s outpatient clinic. Physiother Theory Pract. 2015;31:293–8.CrossRefPubMed
Metadata
Title
Importance of psychological factors for the recovery from a first episode of acute non-specific neck pain - a longitudinal observational study
Authors
Brigitte Wirth
B. Kim Humphreys
Cynthia Peterson
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Chiropractic & Manual Therapies / Issue 1/2016
Electronic ISSN: 2045-709X
DOI
https://doi.org/10.1186/s12998-016-0090-2

Other articles of this Issue 1/2016

Chiropractic & Manual Therapies 1/2016 Go to the issue