Simple neck pain questions used in surveys, evaluated in relation to health outcomes: a cohort study

A cohort of university students (baseline age 19–25 years) were recruited in 2002 and followed annually for 4 years. The baseline response rate was 69% which resulted in 1200 respondents (627 women, 573 men). Participants were asked about present and past pain and perceptions of their general health, sleep disturbance, stress and energy levels, and general performance. The data were analyzed using a mixed model for repeated measurements and a random intercept logistic model.When reporting present pain, participants also reported lower prevalence of very good health, higher stress and sleep disturbance scores and lower energy score. Among those with current neck pain, additional questions characterizing the pain such as duration (categorized), additional pain sites and decreased general performance were associated with lower probability of very good health and higher amounts of sleep disturbance. Knowing about the presence or not of pain explains more of the variation in health between individuals, than within individuals.This study of young university students has demonstrated that simple neck pain survey questions capture features of pain that affect aspects of health such as perceived general health, sleep disturbance, mood in terms of stress and energy. Simple pain questions are more useful for group descriptions than for describing or following pain in an individual.In epidemiological cohort or surveillance studies, where musculoskeletal pain is only one health aspect among many others investigated, the multidimensional aspects of pain have to be captured in only a few variables. Therefore, multi-item instruments for pain assessment are not suitable for the epidemiological survey setting. In the present paper, we term such assessments ‘simple’, as they only capture simple characteristics of pain, such as its presence or duration [1-8], and are usually dichotomous. They do not address deeper qualities, such as intensity, character, or impact on life.Assessment of