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Pain in the Neck No More
18 February 2008 | Lund, Sweden – This month marks a major milestone for musculoskeletal science with the publishing of the long-awaited report by the international Bone and Joint Decade 2000–2010 Task Force on Neck Pain.
A project begun in 2000 at the start of the Decade, the findings of the BJD Task Force on Neck Pain and Its Associated Disorders, published in the journal Spine on February 15, 2008, will have a significant impact on the manner in which neck pain is perceived, treated and studied around the world.
The multidisciplinary, international Task Force led by Prof Scott Haldeman from the University of California in Irvine and in L.A., involved more than 50 researchers based in 9 countries and represented 14 different clinical and scientific disciplines in 8 universities. The group assembled the best international research data on neck pain and related disorders – specifically more than 31,000 research citations with subsequent analysis of over 1,000 studies – making this monumental document one of the most extensive reports on the subject of neck pain ever developed, and offering the most current expert perspective on the evidence related to the treatment of neck pain.
“This authoritative study represents an key step toward increased recognition of the problem of neck pain and the value of a systematic, evidence-based approach to the problem. Not only does the Task Force provide documented guidelines, but they also identified areas for further research, including new approaches to prevention following the identification of risk factors," said Prof Lars Lidgren, Chairman of the Bone and Joint Decade. “Furthermore, it highlights the need for other evidence-based guidelines to address the common, costly, and underestimated burden of musculoskeletal disease.
A key component of the report is a new four-level classification system for neck pain, with the majority patients falling into the Grade I and Grade II categories of this scale. Problems of this type do not involve any major structural cause of their pain and generally do not need extensive tests or invasive treatments, the Task Force suggests. However, especially if pain is interfering with the patient's daily activities (Grade II), some type of early treatment is recommended to prevent long-term disability. In patients where no apparent cause of the pain is detectable, treatment options include pain medications; exercise or physical therapy; or some form of manual therapy – with the key focus being on regaining function and returning the patient to their normal daily activities.
If the pain is associated with a neurological abnormality (Grade III)—for example, decreased reflexes or weakness— further tests are recommended. For these patients, treatment options may include steroid injections or surgery. When there are signs of major structural problems (Grade IV)—for example, fracture, muscle disease, or tumours—immediate specialised evaluation and treatment are vital, writes the Task Force.
Other subjects addressed in the Task Force report include the growing problem of whiplash-associated disorders. Practitioners have long been divided on the validity of whiplash injuries, but new reaserch discussed in the report offers new insight into the risk factors for persistent neck pain and related symptoms after an accident, as well as the physical, psychological, and economic factors which affect recovery.
The results of this unique work have been presented at leading international spine congresses in Switzerland, Canada, Portugal, and the USA, with more planned for the coming year.
The 234-page report is available online at
http://www.spinejournal.org/pt/re/spine/home.htm;jsessionid=HSMDr142HnGftJSL161X5cb61Yy75LJNf9WKpyHRR920TB6stxdR!607026366!181195629!8091!-1
with the Executive Summary downloadable free of charge at
http://www.spinejournal.org/pt/re/spine/executivesummary.htm;jsessionid=H1WcR1xLJ0sP46c9VmdS2LHSPgHnG53y3bL7LTB58npfwkWCFXLN!-809317659!181195629!8091!-1
It is also published as a special edition in both the North American and European editions of SPINE.
About Neck Pain
Neck pain is one of the most pervasive musculoskeletal complaints: according to the journal Spine, statistics typically note that between 30 and 50 % of people experience neck pain in any given year and workplace studies estimate that neck pain accounts for up to 11% percent of claims for days off work on sick leave. And for those who suffer from it, in at least half of cases the neck pain does not completely resolve; the evidence suggest that recovery is affected more by psychological factors and stress than by the actual physical factors, making informed choice of treatment pathways all the more vital to successful outcomes.
About the Bone and Joint Decade
The Bone and Joint Decade 2000 – 2010 was launched in Geneva in January 2000 during a World Health Organization (WHO) conference on “The Burden of Musculoskeletal Conditions at the Start of the New Millennium.” Kofi Annan, secretary general of the United Nations, (UN) endorsed the Bone and Joint Decade on behalf of the United Nations. The driving force behind this initiative was the recognition among healthcare professionals and patient advocates of the significant impact and the growing burden of bone and joint disorders on society, healthcare systems and individuals, and that no single organisation alone could accomplish the desired benefits.
Professor Lars Lidgren, chairman of the Bone and Joint Decade, and head of the Department of Orthopaedics at the University of Lund in Sweden, said: ““Musculoskeletal disorders are the leading cause of disability around the world, affecting one out of every four adults and accounting for 25% of the total cost of illness. Our vision is a society where prevention, treatment and care of people with musculoskeletal disorders are of high standard and accessible around the world – our work is focused to this end.
The Decade aims to build awareness of the burden of musculoskeletal conditions by educating the public and driving research and legislation, which will lead to the improvement of care. The Bone and Joint Decade is a global initiative with localised national strategies and actions.
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