Epidemiology of Neck Pain and Its Impact on Quality-of-Life-A Population-Based, Cross Sectional Study in Singapore

Spine (Phila Pa 1976). 2021 Nov 15;46(22):1572-1580. doi: 10.1097/BRS.0000000000004071.


Study design: Cross-sectional, epidemiological study.

Objective: This study aims to describe the prevalence, risk factors, disability, and quality of life (QoL) burden of neck pain.

Summary of background data: Neck pain is an increasingly common symptom that results in significant disability and loss of QoL to the individual, and imposes a considerable economic burden to developed countries.

Methods: A cross-sectional, questionnaire-based study was conducted via multistage random sampling of public households in Singapore on individuals aged 21 and older. Questionnaires were administered face-to-face by trained interviewers. Data analyzed included the prevalence and characteristics of neck pain, its relationship with sociodemographic factors, and its association on QoL and disability via validated questionnaires: EQ5D questionnaire and Neck Disability Index (NDI), respectively.

Results: A total of 626 individuals with a median age of 52.0 years (interquartile range 37.0-67.0), and even sex distribution of males (54.0%) and females (46.0%) were included in this study. A total of 144 individuals reported neck pain over the past 6 months, giving a 6-month period prevalence of 23.0%. Among them, nine (6.3%) had chronic, whereas 12 (8.3%) had severe neck pain. Female sex was the only significant risk factor for neck pain on multivariate analysis, with a risk ratio of 1.34 (95% confidence interval [CI] 1.00-1.80, P = 0.049). Individuals with neck pain had mean raw NDI scores of 4.91 ± 6.25, with higher disability seen with increasing pain duration and intensity (P < 0.001 and P = 0.002 respectively). Compared to individuals without neck pain, those with neck pain had poorer QoL with lower EQ5D-Index scores (0.84 ± 0.25 vs. 0.93 ± 0.15; 95% CI 0.046-0.132, P < 0.001) and EQ5D-VAS scores (68.76 ± 14.59 vs. 73.86 ± 13.64; 95% CI 2.510-7.697, P < 0.001).

Conclusion: Our findings show that neck pain is a prevalent condition with chronicity and severity of symptoms associated with reduced QoL and increased disability. Population sample health scores can serve as potential reference targets in disease management and aid national health care policy-making.Level of Evidence: 3.

MeSH terms

  • Cross-Sectional Studies
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck Pain* / diagnosis
  • Neck Pain* / epidemiology
  • Quality of Life*
  • Singapore / epidemiology
  • Surveys and Questionnaires