An overview of psychosocial and behavioral factors in neck-and-shoulder pain.

Psychological factors are suspected to be pertinent in the etiology, maintenance, treatment and prevention of neck and shoulder pain problems. I present a broad overview of current knowledge and trends concerning cognitive-behavioral factors for these pain problems. Although there is a dire lack of research concerning cognitive-behavioral approaches and no psychological theory specific to neck and shoulder problems is currently available, a good deal is nevertheless known about musculoskeletal pain in general. Consequently, there is reason to believe that these factors may be involved in the etiology of neck-and-shoulder disorders. In particular, psychological factors appear to be important in the development and maintenance of subacute and chronic problems. Treatment techniques, adherence, and prevention are examined from a psychological perspective. The application of cognitive-behavioral factors to the treatment and prevention of neck and shoulder pain should provide new avenues which enhance results. It is concluded that while a lack of research precludes definite conclusions, there is ample reason to believe that research into psychological factors may well result in a better understanding of neck and shoulder pain and enhanced treatment and prevention outcomes.