Predictors of persistent pain in patients with acute neck pain treated with physical therapy: A prospective study with 2 years follow up

Musculoskeletal Care. 2023 Dec;21(4):980-986. doi: 10.1002/msc.1775. Epub 2023 May 4.


Background: Clinicians specialising in musculoskeletal medicine have observed that patients with neck pain often seek repeat consultations because of recurring neck pain. Despite this pattern, there is a lack of research exploring the persistence nature of neck pain. Understanding potential predictors of persistent neck pain could help clinicians develop effective treatment approaches to prevent the chronicity of these conditions.

Objective: The current study investigated the potential predictors of persistent neck pain over a 2-year period among patients with acute neck pain treated with physical therapy.

Methods: A longitudinal study design was employed. Data were collected at baseline and at 2-year follow-up from 152 acute neck pain patients aged (29.2 ± 6.7). Patients were recruited from physiotherapy clinics. Logistic regression was used for analysis. At 2-year follow-up, participants were reassessed for their pain intensity (Dependent variable) and categorised as recovered or reporting persistent neck pain. Baseline acute neck pain intensity, sleep quality, disability, depression, anxiety, and sleepiness were used as potential predictors.

Results: Among 152 participants, 51 (33.6%) patients with acute neck pain reported persistent neck pain at 2-year follow-up. 43% of the variation in the dependent variable was explained by the model. Despite the strong correlations between persistent pain at follow-up with all potential predictors, only sleep quality 95% CI (1.1,1.6), and anxiety 95% CI (1.1,1.4) were the significant predictors of persistent neck pain.

Conclusion: Our results suggest that poor sleep quality and anxiety may serve as potential predictors of persistent neck pain. The findings highlight the importance of a comprehensive approach to managing neck pain that addresses both physical and psychological factors. By targeting these co-morbidities, healthcare providers may be able to improve outcomes and prevent the progression of the case.

Keywords: anxiety; persistent neck pain; sleep disturbance.

MeSH terms

  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Neck Pain* / therapy
  • Physical Therapy Modalities*
  • Prospective Studies