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Review
. 2016 Dec 30:10:746-756.
doi: 10.2174/1874325001610010746. eCollection 2016.

A Qualitative Description of Chronic Neck Pain has Implications for Outcome Assessment and Classification

Affiliations
Review

A Qualitative Description of Chronic Neck Pain has Implications for Outcome Assessment and Classification

Joy C MacDermid et al. Open Orthop J. .

Abstract

Background: Neck pain is common, but few studies have used qualitative methods to describe it.

Purpose: To describe the quality, distribution and behavior of neck pain.

Methods: Sixteen people (15 females; mean age = 33 years (range = 20-69)) with neck pain >3 months were interviewed using a semi-structured guide. Interview data were recorded and transcribed verbatim. Descriptive content analysis was performed by two authors. Participants then completed an electronic descriptive pain tool, placing icons (word and icon descriptors to describe quality) on anatomic diagrams to identify location of pain, and intensity ratings at each location. This data was triangulated with interviews.

Results: Aching pain and stiffness in the posterior neck and shoulder region were the most common pain complaints. All patients reported more than one pain quality. Associated headache was common (11/16 people); but varied in location and pain quality; 13/16 reported upper extremity symptoms. Neuropathic characteristics (burning) or sensory disturbance (numbness/tingling) occurred in some patients, but were less common. Activities that involved lifting/carrying and psychological stress were factors reported as exacerbating pain. Physical activity was valued as essential to function, but also instigated exacerbations. Concordance between the structured pain tool and interviews enhanced trustworthiness of our results. Integrating qualitative findings with a previous classification system derived a 7-axis neck pain classification: source/context, sample subgroup, distribution, duration, episode pattern, pain/symptom severity, disability/participation restriction.

Conclusions: Qualitative assessment and classification should consider the multiple dimensions of neck pain.

Keywords: Classification; Neck pain; Qualitative; Structured pain tool; Thematic analysis; Whiplash.

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Figures

Fig. (1)
Fig. (1)
The iconic map created by a participant with “classic” moderate neck pain that is localized, aching neck pain with stiffness in the area of trapezius. The numbers indicate the intensity rating given to each type of pain (0=no pain, 10=worst).
Fig. (2)
Fig. (2)
The iconic map created by a participant with diffuse high intensity neck pain characterized by variability in location (neck, head, hands, thoracic and lower spine) and quality of pain (pounding, stiffness, burning and aching). The numbers indicate the intensity rating given to each type of pain (0=no pain, 10=worst).

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