Utility of restricted neck movement as a diagnostic criterion in case definition for neck disorders.
Reading I., Walker-Bone K., Palmer KT., Cooper C., Coggon D.
OBJECTIVES: This study explored the utility of restricted neck movement in epidemiologic case definition for neck disorders. METHODS: Data on neck pain, sensory symptoms in the arm, psychosocial and physical risk factors for neck disorders, and the range of active neck movements were obtained through a self-administered questionnaire, interview, and physical examination for a community-based sample of 2145 adults aged 25-64 years. The prevalence of neck pain and sensory symptoms was examined according to the extent of neck movements. Logistic regression was used to assess the relation of risk factors to neck disorders, defined by various combinations of pain and restricted movement, and the associations were compared. RESULTS: The ranges of different categories of neck movement were correlated within persons, and their sum ("total neck movement") was unimodally distributed across persons. The prevalence of neck pain and sensory symptoms was elevated when total neck movement was below the 30th centile, and particularly below the 10th centile. Associations between neck pain and low vitality and poor support at work were stronger when there was also restricted neck movement, but the extent of neck movement did not materially modify the relation of neck pain to physical risk factors. CONCLUSIONS: The restriction of total neck movement may serve as a marker of severity in community-based studies of neck disorders, but no indication was found that it distinguishes a subset of cases with a distinct etiology.