Is it time for a population health approach to neck pain?
From: J Manipulative Physiol Ther. 2008 Jul-Aug;31(6):442-6
Neck pain and its associated disorders cause significant health burden in the general population and after road traffic and occupational injury. Individual level health care treatments have been well studied, but population health approaches to this problem have not. In this study they used a best evidence synthesis to examine population level approaches to the prevention and control of neck pain and its associated disorders.
The systematic review examined studies published between 1980 and 2006 that addressed the incidence, prevalence, risk factors, prevention, cost, assessment and classification, interventions, and course and prognostic factors for neck pain and its associated disorders. Citations were screened for relevance, scientifically reviewed, and synthesized. Valid studies addressing public policies or population level approaches to the prevention and control of neck pain and its associated disorders were identified and used in the evidence synthesis.
Only 8 of the 552 scientifically admissible studies were considered relevant to a public or population health approach to preventing and controlling the burden of neck pain and its associated disorders. For whiplash associated disorders, active head restraints and seat backs were protective in rear end collisions; insurance policies affected the incidence and recovery; government funding of multidisciplinary rehabilitation programs did not benefit recovery; and early intensive health care delayed recovery. In the workplace, 2 randomized trials failed to show any preventive effect for ergonomic interventions or physical training and stress management. One study documented the societal cost of neck pain.
The authors concluded there is little evidence on which to make public or population level recommendations, despite the important public health burden and costs of neck pain and its associated disorders. Population level approaches to preventing and controlling neck pain and its associated disorders should be investigated.
