Limited Prognostic Value of Pain Duration in Non-Specific Neck Pain
- RRS Education
Chronic pain has been defined as persistent or recurrent pain lasting longer than several months (typically 3 months). The 3-month cut-off, however, has been challenged as a prognostic factor as well as its use in clinical decision making. Neck pain in general has been shown to be one of the leading causes of disability worldwide and its prevalence and ‘years lived with disability’ is increasing.
Pain duration as a prognostic factor relating to clinical outcome in neck pain patients has been reported by several researchers. However, patients in these studies mainly had pain of any duration and were categorized into acute, sub-acute and chronic, but with categories defined as having varying durations. Cecchi et al. found that pain duration was not a significant prognostic factor in chronic (6 months or more) neck pain patients.
Studies that reported pain duration as influencing outcomes typically determined whether there was an increased risk associated with longer pain duration versus a shorter pain duration, but this type of comparison does not inform about the amount of variance in outcome that is explained by pain duration. Variance is a measure of how much a data set is spread out. Because of this and other methodological weaknesses of previous studies, several questions remain.
The focus of the current study was to investigate whether pain duration has an influence on treatment outcome when only chronic patients with pain duration longer than 3 months are considered.
The authors also assessed in patients of any pain duration: 1) how much variance in outcome is explained by pain duration; and 2) whether a model identified in a training dataset predicts outcome in independent data.
THIS WEEK'S RESEARCH REVIEW: “Limited Prognostic Value of Pain Duration in Non-Specific Neck Pain”
This paper was published in the European Journal of Pain (2022) and this Review is posted in Recent Reviews, Neck Pain and the 2022 Archive.