Triage
Ever since the 1994 CSAG report was published for lower back pain, there has been a considerable lag in the classification and treatment for neck pain sufferers. The ability of Chartered Physiotherapists and GP's to detect neck pain caused by significant causes is a high priority and also neck pain associated with neurological impairment.
Approach to diagnosis (triage):
Neck pain can be classified as follows:
Grade 1: No signs of major pathology and little interference with daily activities
Grade 2: No signs of major pathology but may impact daily activities
Grade 3: Neck pain with neurological signs or symptoms (radiculopathy)
Grade 4: Neck pain with major pathology (e.g., fracture, myelopathy, neoplasm, spinal infection).
How big is the problem?
Neck pain is a common condition that can cause significant functional and sociual limitations. Many decades of research have confirmed that your approach to symptoms is crucial; if you avoid daily activities, take extended bed rest, take extended time off work and hobbies then you are more likley to have a poor outcome and develop chronic pain syndrome.
Over a lifetime, existing statistics show that "a significant episode" of neck pain is found in 40% to 70% of people in their lifetime with the worldwide point prevalence being nearly 5%. Between 33-65% of people recover from an episode of neck pain within 12 months, but relapses are common. Up to 20% of acute neck pain will go on to become chronic neck pain but again, your early actions can help mitigate this risk!
In the 2010 Global Burden of Disease Study, neck pain ranked fourth highest for the number of years lived with disability.
Neck pain increases from 18-30 years of age through to middle age (50-55 years). All large scale studies show women having higher rates of neck pain than men.
Injury is a strong predictor of developing chronic neck pain. This has mainly been described for whiplash; 20% to 40% of whiplash injury patients will go on to have chronic neck pain.
High body mass index, frequent neck extension during the working day, high initial pain intensity, and high psychological job demands are all predictors of chronic neck pain development in office workers.
Cervical radicular pain (ie. neck pain that is associated with arm pain below th eelbow) has an annual incidence of 63-107 cases per 100,000, and incidence peaks in the fourth and fifth decades.
