Cervical related disability – interactions of pain features, psychological states and clinical presentation

Abstract

Background: Cervical pain related to different spine pathologies is a major cause of disability. The relationship between clinical patterns, pain, psychological states was demonstrated. Disability in patients with cervical pain remains still high. Material and methods: A total of 42 patients (14 males, 28 females) with cervical pain were assed using visual analogue scale (VAS), hospital anxiety and depression scale (HADS), patient health questionare-9 (PHQ-9), neck disability index (NDI) and other clinical data. Results: Acute pain was present in 24 % of patients while gradual in 76%. Among clinical patterns the most common form was referred pain (52%) followed by axial neck pain (33%) and radiculopathy in (14%). NDI correlated with pain intensity (VAS) and the psycho-emotional state (for HADS and PHQ-9, p < 0.001). A higher depression score was found in patient with referred pain and radiculopathy (mean 8.0 points ±4 points according to PHQ9 score). Also, NDI was higher in patients with comorbidities, current joint pain and systemic disorders, referred pain, with acute onset, and no previous trauma. Conclusions: The results from the current study highlighted an association between NDI and pain intensity and psychological state, predominantly in the group with referred pain, and radiculopathy. Acute cervical pain, with no previous trauma, with systemic disorders and other joint pain interfered with a higher risk for developing disabilities. Further research looking at multiple factors such as clinical presentation features of cervical pain and clinical outcomes will additionally guide the development of adequate management strategies for cervical pain.