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A New Conceptual Model of Neck Pain

Linking Onset, Course, and Care: The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

  • Conceptual Model
  • Published:
European Spine Journal Aims and scope Submit manuscript

Study Design

Iterative discussion and consensus by a multidisciplinary task force scientific secretariat reviewing scientific evidence on neck pain and its associated disorders.

Objective

To provide an integrated model for linking the epidemiology of neck pain with its management and consequences, and to help organize and interpret existing knowledge, and to highlight gaps in the current literature.

Summary of Background Data

The wide variability of scientific and clinical approaches to neck pain described in the literature requires a unified conceptual model for appropriate interpretation of the research evidence.

Methods

The 12-member Scientific Secretariat of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders critically reviewed and eventually accepted as scientifically admissible a total of 552 scientific papers. The group met face-to-face on 18 occasions and had frequent additional telephone conference meetings over a 6-year period to discuss and interpret this literature and to agree on a conceptual model, which would accommodate findings. Models and definitions published in the scientific literature were discussed and repeatedly modified until the model and case definitions presented here were finally approved by the group.

Results

Our new conceptual model is centered on the person with neck pain or who is at risk for neck pain. Neck pain is viewed as an episodic occurrence over a lifetime with variable recovery between episodes. The model outlines the options available to individuals who are dealing with neck pain, along with factors that determine options, choices, and consequences. The short- and long-term impacts of neck pain are also considered. Finally, the model includes a 5-axis classification of neck pain studies based on how subjects were recruited into each study.

Conclusion

The Scientific Secretariat found the conceptual model helpful in interpreting the available scientific evidence. We believe it can assist people with neck pain, researchers, clinicians, and policy makers in framing their questions and decisions.

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Author information

Authors and Affiliations

  1. Department of Medicine, University of British Columbia, Columbia, Canada

    Jaime Guzman MD, MSc, FRCP(C)

  2. Occupational Health and Safety Agency for Healthcare in BC, Vancouver, Canada

    Jaime Guzman MD, MSc, FRCP(C)

  3. Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Mānoa, Honolulu, HI, USA

    Eric L. Hurwitz DC, PhD

  4. Department of Public Health Sciences, and the Alberta Centre for Injury Control and Research, School of Public Health, University of Alberta, Edmonton, Canada

    Linda J. Carroll PhD

  5. Department of Neurology, University of California, Irvine, CA, USA

    Scott Haldeman DC, MD, PhD

  6. Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA

    Scott Haldeman DC, MD, PhD & Margareta Nordin PT, DrMedSci

  7. Departments of Public Health Sciences and Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

    Pierre Côté DC, PhD, Margareta Nordin PT, DrMedSci & J. David Cassidy DC, PhD, DrMedSc

  8. Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, Canada

    Pierre Côté DC, PhD, Gabrielle van der Velde DC, Margareta Nordin PT, DrMedSci & J. David Cassidy DC, PhD, DrMedSc

  9. Institute for Work & Health, Toronto, Canada

    Pierre Côté DC, PhD, Gabrielle van der Velde DC, Sheilah Hogg-Johnson PhD, Margareta Nordin PT, DrMedSci & J. David Cassidy DC, PhD, DrMedSc

  10. Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Canada

    Pierre Côté DC, PhD & Gabrielle van der Velde DC

  11. Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA

    Eugene J. Carragee MD, FACS

  12. Orthopaedic Spine Center and Spinal Surgery Service, Stanford University Hospital and Clinics, Stanford, CA, USA

    Eugene J. Carragee MD, FACS

  13. Endocrinology, Analgesia and Inflammation, Merck & Co., Rahway, NJ, USA

    Paul M. Peloso MD, MSc, FRCP(C)

  14. Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

    Gabrielle van der Velde DC & Margareta Nordin PT, DrMedSci

  15. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    Lena W. Holm DrMedSc

  16. Department of Public Health Sciences, University of Toronto, Toronto, Canada

    Sheilah Hogg-Johnson PhD

  17. Departments of Orthopaedics and Environmental Medicine and Program of Ergonomics and Biomechanics, School of Medicine and Graduate School of Arts and Science, New York University, New York, NY, USA

    Margareta Nordin PT, DrMedSci

  18. Occupational and Industrial Orthopaedic Center (OIOC), New York University Medical Center, New York, USA

    Margareta Nordin PT, DrMedSci

  19. 1195 West Broadway, Suite 301, Vancouver, BC, Canada, V6H 3X5

    Jaime Guzman MD, MSc, FRCP(C)

Authors
  1. Jaime Guzman MD, MSc, FRCP(C)
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  2. Eric L. Hurwitz DC, PhD
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  3. Linda J. Carroll PhD
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  4. Scott Haldeman DC, MD, PhD
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  5. Pierre Côté DC, PhD
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  6. Eugene J. Carragee MD, FACS
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  7. Paul M. Peloso MD, MSc, FRCP(C)
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  8. Gabrielle van der Velde DC
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  9. Lena W. Holm DrMedSc
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  10. Sheilah Hogg-Johnson PhD
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  11. Margareta Nordin PT, DrMedSci
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  12. J. David Cassidy DC, PhD, DrMedSc
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Corresponding author

Correspondence to Jaime Guzman MD, MSc, FRCP(C).

Additional information

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Reprinted with permission from Lippincott Williams & Wilkins, Guzman J, Hurwitz EL, Carroll LJ, et al., A New Conceptual Model of Neck Pain, Linking Onset, Course, and Care: The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders, SPINE, Volume 33, Number 4S, pp S14–S23

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Guzman, J., Hurwitz, E.L., Carroll, L.J. et al. A New Conceptual Model of Neck Pain. Eur Spine J 17 (Suppl 1), 14–23 (2008). https://doi.org/10.1007/s00586-008-0621-1

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  • DOI: https://doi.org/10.1007/s00586-008-0621-1

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