A study about neck pain on active population who visit Primary Health Centers.

BACKGROUND: Cervical pain is very common among population and several methods have been used until now in order to evaluate it. The main aim of this study is to estimate the prevalence of non-specific neck pain and the special features of it through its relation to demographic agents, habits and physiology parameters. Additionally, this study aims to select the most valid and objective methods for neck pain evaluation, which could also be useful in Primary Health Care and could give new prospectives. METHODS: This is a cross sectional study with a sample of 440 people 20-40 years old who visited the Public Centers in the County of Thessaloniki. The sample was chosen randomly. The subjects were separated in two groups (neck pain and no pain group). A questionnaire was distributed to the sample. The devices were an algometer which was used to estimate pain threshold and an electronic hand watch/smartphone which was used to evaluate pulse and skin humidity. RESULTS: The 38.6% of the samples seemed to suffer from neck pain but real neck pain was found only in the 21% of the sample. The disturbance in neck area because of stiffness and fatigue was found in 51% of the subjects and 25.9% of theme felt both pain and fatigue. The factors which were related to neck pain were female sex (p<0.001), age after 40 (p=0.007), marriage status (p=0.042), smocking (p=0.034), lack of physical exercise (p=0.01) and stress (p<0.001). Neck pain was strongly associated to pain pressure thresholds (PPT) (p<0.001). The PPT were lower in the group who suffered from neck pain. The agents which were not statistically associated with neck pain were the hardness of work (p=0,369), computer use (p=0.07), educational level (p=0.274), alcohol consumption (p=0.748), siesta (p=0.913), depression (p=0.086), heart rate (p=0.216) and skin humidity (p=0.141). There was no correlation between NRS and pain thresholds (p=0.947). The majority of people seemed to suffer from mild disability caused by neck pain (56.7%). Almost the half of the sample did not asked for professional help for their neck pain (48%) and seemed to be ignorant about the role of general practitioner at the management of their neck pain (44.1%). CONCLUSION: The examination of the patients showed that neck pain is often confused with stiffness and fatigue at the neck area. The NDI and HADS questionnaires could be easily used to evaluate respectively the disability and the psychological status of a person who suffers from neck pain. Algometry seems to enhance the objectiveness at the field of neck pain evaluation. The algometer showed high validity and reliability as a mean of neck pain evaluation under the condition that it is applied by a health professional with experience on its use. Neck pain is a complexed symptom and should be evaluated from an integrated point of view. These tools could probably be used in Primary Health Care as contemporary resources in the medical practice but more research is needed.

Specific neck pain algometric measurements and their relation to heart rate and skin humidity.

Cervical pain is very common in general population but only few methods have been used to evaluate it with objectiveness. There are only few studies which use algometer as a means of neck pain assessment. Studies have shown that algometer could be used in pain evaluation but more studies are necessary to support this. The main purpose of the study was the evaluation of algometer as a means of an objective measurement of pain threshold to people with non-specific neck pain. The study focused on the search of correlation between neck pain and pain pressure threshold (PPT) after recording the number of the minimum pain feeling in the sample with the pressure of the algometer at specific neck points. The study also aimed at searching the correlation of neck pain with heart rate and skin humidity. This is a part of a cross-sectional study which was held during a PhD study which assessed 185 randomly chosen people, 20-60 years old, who visited all the Public Centers in the County of Thessaloniki. The sample was separated in two groups according to the frequency of their neck pain, those who suffered frequently or almost every day from non-specific neck pain (neck pain group) and those with non-specific neck pain occasionally, rarely or never suffered from it (no pain group). Subjects were randomly chosen from people who visited the Public Centers for any reason. Neck pain was strongly associated with PPT (P<0.001). Heart rate (P=0.216) and skin humidity (P=0.14) were not significantly related to neck pain. According to the results the algometer seems to be a useful tool as a mean of neck pain evaluation and algometry seems to enhance the idea of pain quantification. However more evidence is needed and more studies should be conducted in order to strengthen our results. Latter studies should be designed with more accuracy focusing on details in order to establish algometry as an objective method of pain evaluation.