Hogg-Johnson Sheilah, van der Velde Gabrielle, Carroll Linda J, Holm Lena W, Cassidy J David, Guzman Jamie, Côté Pierre, Haldeman Scott, Ammendolia Carlo, Carragee Eugene, Hurwitz Eric, Nordin Margareta, Peloso Paul
Institute for Work and Health, Toronto, Canada.
J Manipulative Physiol Ther. 2009 Feb;32(2 Suppl):S46-60. doi: 10.1016/j.jmpt.2008.11.010.
Best evidence synthesis.
To undertake a best evidence synthesis of the published evidence on the burden and determinants of neck pain and its associated disorders in the general population.
The evidence on burden and determinants of neck has not previously been summarized.
The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders performed a systematic search and critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Studies meeting criteria for scientific validity were included in a best evidence synthesis.
We identified 469 studies on burden and determinants of neck pain, and judged 249 to be scientifically admissible; 101 articles related to the burden and determinants of neck pain in the general population. Incidence ranged from 0.055 per 1000 person years (disc herniation with radiculopathy) to 213 per 1000 persons (self-reported neck pain). Incidence of neck injuries during competitive sports ranged from 0.02 to 21 per 1000 exposures. The 12-month prevalence of pain typically ranged between 30% and 50%; the 12-month prevalence of activity-limiting pain was 1.7% to 11.5%. Neck pain was more prevalent among women and prevalence peaked in middle age. Risk factors for neck pain included genetics, poor psychological health, and exposure to tobacco. Disc degeneration was not identified as a risk factor. The use of sporting gear (helmets, face shields) to prevent other types of injury was not associated with increased neck injuries in bicycling, hockey, or skiing.
Neck pain is common. Nonmodifiable risk factors for neck pain included age, gender, and genetics. Modifiable factors included smoking, exposure to tobacco, and psychological health. Disc degeneration was not identified as a risk factor. Future research should concentrate on longitudinal designs exploring preventive strategies and modifiable risk factors for neck pain.
最佳证据综合分析。
对已发表的关于普通人群颈部疼痛及其相关疾病的负担和决定因素的证据进行最佳证据综合分析。
此前尚未对颈部负担和决定因素的证据进行总结。
2000 - 2010年骨与关节十年颈部疼痛及其相关疾病特别工作组对1980年至2006年间发表的文献进行了系统检索和批判性综述,以收集有关颈部疼痛的最佳证据。符合科学有效性标准的研究被纳入最佳证据综合分析。
我们确定了469项关于颈部疼痛负担和决定因素的研究,判定其中249项在科学上可接受;101篇文章涉及普通人群颈部疼痛的负担和决定因素。发病率从每1000人年0.055例(伴有神经根病的椎间盘突出症)到每1000人213例(自我报告的颈部疼痛)不等。竞技运动中颈部损伤的发病率从每1000次暴露0.02例到21例不等。疼痛的12个月患病率通常在30%至50%之间;限制活动的疼痛的12个月患病率为1.7%至11.5%。颈部疼痛在女性中更为普遍,且患病率在中年达到峰值。颈部疼痛的风险因素包括遗传、心理健康不佳和接触烟草。未发现椎间盘退变是风险因素。使用运动装备(头盔、面罩)预防其他类型的损伤与骑自行车、曲棍球或滑雪时颈部损伤增加无关。
颈部疼痛很常见。颈部疼痛的不可改变风险因素包括年龄、性别和遗传。可改变因素包括吸烟、接触烟草和心理健康。未发现椎间盘退变是风险因素。未来的研究应集中在探索颈部疼痛预防策略和可改变风险因素的纵向设计上。