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首发与复发性非特异性颈部疼痛:临床特征、恢复情况以及疼痛严重程度对幸福感和功能的影响。

First-episode vs recurrent nonspecific neck pain: clinical characteristics, recovery, and the impact of pain severity on well-being and functionality.

作者信息

Verwoerd Martine J, Wittink Harriet, Maissan Francois, van Kuijk Sander M J, Smeets Rob J E M

机构信息

Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, the Netherlands.

Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, the Netherlands.

出版信息

Pain Rep. 2025 Apr 3;10(3):e1259. doi: 10.1097/PR9.0000000000001259. eCollection 2025 Jun.

Abstract

OBJECTIVE

This study (1) compared clinical characteristics between patients with first-episode and recurrent nonspecific neck pain (NSNP), and (2) examined differences in daily activities and psychological well-being between patients with minimal pain (1-2 numeric pain rating scale) and moderate to severe pain (≥3 numeric pain rating scale) at 6 weeks postpresentation.

METHODS

The study was conducted across 30 primary physiotherapy practices and included patients experiencing a new NSNP episode lasting ≤12 weeks. For the first research objective, baseline data collection encompasses neck pain symptoms, prior conditions, and work-related, general, psychological, and behavioral factors. In addition, pain intensity was measured at 6-week, 3-month, and 6-month follow-ups. For the second objective, pain intensity, psychological factors, and disability were assessed.

RESULTS

No clinically meaningful differences were observed in clinical characteristics or recovery rates between patients with first-episode and recurrent NSNP. However, meaningful differences were found in disability, patient concerns, and self-efficacy between minimal and moderate to severe pain groups at 6 weeks. Patients with higher pain intensity had higher disability scores (1.33-point [SD 0.84-1.81]) difference on a 0 to 7 scale, lower self-efficacy (-1.25-point [SD -1.84 to -0.65]) difference on a 0 to 12 scale, and greater concerns (1.87-point [SD 1.21-2.52] difference on a 0 to 10 scale).

CONCLUSION

No clinically meaningful differences in clinical characteristics or pain recovery rates exist between first-episode and recurrent NSNP. However, significant and clinically meaningful differences exist in the impact of pain severity on daily activities, patient concerns, and self-efficacy.

摘要

目的

本研究(1)比较首次发作和复发性非特异性颈部疼痛(NSNP)患者的临床特征,(2)检查就诊后6周时轻度疼痛(数字疼痛评分量表评分为1 - 2分)和中度至重度疼痛(数字疼痛评分量表评分≥3分)患者在日常活动和心理健康方面的差异。

方法

该研究在30家初级物理治疗机构开展,纳入了新发生的持续时间≤12周的NSNP发作患者。对于第一个研究目标,基线数据收集包括颈部疼痛症状、既往疾病以及与工作相关、一般、心理和行为因素。此外,在6周、3个月和6个月随访时测量疼痛强度。对于第二个目标,评估疼痛强度、心理因素和残疾情况。

结果

首次发作和复发性NSNP患者在临床特征或恢复率方面未观察到具有临床意义的差异。然而,在6周时,轻度和中度至重度疼痛组在残疾、患者担忧和自我效能方面存在有意义的差异。疼痛强度较高的患者在0至7分的量表上残疾评分更高(差异为1.33分[标准差0.84 - 1.81]),在0至12分的量表上自我效能更低(差异为 - 1.25分[标准差 - 1.84至 - 0.65]),在0至10分的量表上担忧程度更高(差异为1.87分[标准差1.21 - 2.52])。

结论

首次发作和复发性NSNP在临床特征或疼痛恢复率方面不存在具有临床意义的差异。然而,疼痛严重程度对日常活动、患者担忧和自我效能的影响存在显著且具有临床意义的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0e7/11970887/361bb5961361/painreports-10-e1259-g001.jpg

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