Review article (meta-analysis)Prognosis of Acute Idiopathic Neck Pain is Poor: A Systematic Review and Meta-Analysis
Section snippets
Data Sources and Searches
We conducted this systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were identified through searches of the following databases from their inception to July 2009: EMBASE, CINAHL, Medline, AMED, PEDro, and CENTRAL. Searches were limited to human studies. Key search terms used to identify the study population of interest were: neck pain, neck injury, neck muscles, cervical, or cervical vertebrae. Search terms used to
Results
The search retrieved 20,085 references, of which 6 studies, published in 7 articles, fulfilled our inclusion criteria (table 1).18, 19, 20, 21, 22, 23, 24 Two articles20, 22 reported the same participant population and were considered a single study. Three of the included studies used an inception cohort design, following the course of acute neck pain in participants recruited from chiropractic,21 physiotherapy,23 and general practice20, 22 clinics. The remaining 3 studies were randomized
Discussion
In this study, to our knowledge the first systematic review about the course of acute idiopathic neck pain from its inception, we report that outcomes for acute neck pain are surprisingly poor and resolution is incomplete. There is a rapid decrease in pain by 45% and disability by 43% during the first 6.5 weeks. While this degree of symptom reduction may be clinically worthwhile to some patients,25 the severity and duration of symptom persistence (between 37–42 on a 0–100 scale up to 1y) are
Conclusions
To our knowledge, this study provides the first systematic review and meta-analysis of acute idiopathic neck pain prognosis from its inception. The results show that the prognosis of acute idiopathic neck pain is markedly worse than previously recognized and that resolution is incomplete. This level 1 evidence may be useful for the allocation of health resources by policy makers and can be incorporated into future clinical practice guidelines to guide primary care clinicians when providing
Acknowledgements
We thank research assistant Angie Johnson, BAppSc(Phty), for her excellent technical assistance with this study.
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Supported by the National Health and Medical Research Council, Australia; and an Australian Postgraduate Award provided by the Australian Commonwealth Government.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Published online April 1, 2011 at www.archives-pmr.org.