A Qualitative Description of Chronic Neck Pain has Implications for Outcome Assessment and Classification.

Joy C Macdermid,David M Walton,Pavlos Bobos,Margaret Lomotan,Lisa Carlesso

doi:10.2174/1874325001610010746

Joy C Macdermid, David M Walton + Show 3 more

Open Access

https://doi.org/10.2174/1874325001610010746

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Abstract

Background:Neck pain is common, but few studies have used qualitative methods to describe it.Purpose:To describe the quality, distribution and behavior of neck pain.Methods:Sixteen people (15 females; mean age = 33 years (range = 20-69)) with neck pain >3 months were interviewed using a semi-structured guide. Interview data were recorded and transcribed verbatim. Descriptive content analysis was performed by two authors. Participants then completed an electronic descriptive pain tool, placing icons (word and icon descriptors to describe quality) on anatomic diagrams to identify location of pain, and intensity ratings at each location. This data was triangulated with interviews.Results:Aching pain and stiffness in the posterior neck and shoulder region were the most common pain complaints. All patients reported more than one pain quality. Associated headache was common (11/16 people); but varied in location and pain quality; 13/16 reported upper extremity symptoms. Neuropathic characteristics (burning) or sensory disturbance (numbness/tingling) occurred in some patients, but were less common. Activities that involved lifting/carrying and psychological stress were factors reported as exacerbating pain. Physical activity was valued as essential to function, but also instigated exacerbations. Concordance between the structured pain tool and interviews enhanced trustworthiness of our results. Integrating qualitative findings with a previous classification system derived a 7-axis neck pain classification: source/context, sample subgroup, distribution, duration, episode pattern, pain/symptom severity, disability/participation restriction.Conclusions:Qualitative assessment and classification should consider the multiple dimensions of neck pain.

Highlights

It is estimated that one-third to one-half of all adults will experience neck pain (NP) during the course of one year [1, 2]
NP may be associated with degenerative changes, physical, and psychosocial factors [4 - 6] and is typically episodic [3, 7 - 9]
A descriptive approach is used in qualitative research when there is a need for basic qualitative description of phenomena, as opposed to other qualitative paradigms that might involve interpretation or theory

Summary

Introduction

It is estimated that one-third to one-half of all adults will experience neck pain (NP) during the course of one year [1, 2]. Whiplash injury is the most common traumatic cause of NP [3]. There is a substantial risk of developing chronic symptoms that cause disability, work loss, and health care costs [7, 10]. Structural abnormalities found in diagnostic imaging are weakly associated with intensity and prognosis of NP due to injury [11 - 13], or chronic neck dysfunction [11]. But few studies have used qualitative methods to describe it. Purpose: To describe the quality, distribution and behavior of neck pain

Objectives

Methods

Results