A psychosocial profile of patients presenting with non-specific neck pain to a chiropractic day clinic at a University of Technology

Abstract

BACKGROUND: According to the World Federation of Chiropractic (2009), neck pain (NP) is a common problem responsible for disability. When treating a NP patient, it was important to identify those at risk of developing chronic NP. NP is of multifactorial origin and therefore indicated to be a result of individual, physical and of psychosocial origination (Cassidy et al. 2009). Dvorak et al (2001) identified psychosocial variables that accounted for approximately one-fourth of self-reported pain and approximately one-third of disability. By identifying the psychosocial factors or “yellow flags” with the use of disability questionnaires at an early stage, clinicians are assisted in detecting neck pain before it becomes chronic. This aids in the prevention of chronic spinal pain and disability and allows clinicians to manage the patients using a biopsychosocial approach (Kline 2003). AIM: The study sets out to determine a psychosocial profile and to identify the prevalence of risk factors for chronic pain among patients presenting to the Durban University of Technology (DUT) Chiropractic Day Clinic (CDC) with non-specific neck pain. METHODOLOGY: The design of the study was a quantitative paradigm, using a prospective, descriptive and survey based study. After ethical clearance was gained, the research process began at the DUT CDC. One hundred and nine participants completed informed consent, demographic, Neck Disability Index (NDI) and yellow flags form questionnaires. The NDI was used to assess the chronicity of the participants, while the yellow flags form was used to assess the risk of disability of the participants by using a numeric score at the end of the questionnaire. Both are comprehensive tools used in this study. All the questionnaires were kept confidential and only viewed by the researcher. A code was allocated for each questionnaire before the data was captured and sent to the statistician for data analysis. RESULTS: One hundred and nine questionnaires were utilised for statistical analysis. The population was 109 participants who attended the DUT CDC with complaints of non-specific NP over a four-month period. The participants were aged from eighteen to eighty-one years with a mean of 35. Among the total number of participants, 57.7% were female. The BMI values showed that majority of the participants were overweight and obese, which was 48.4% of the population. Majority of participants, 57.7% gained a tertiary education, while 4.5% obtained no formal education. Non-smokers (77.5%) and non-drinkers (58.6%) were the majority in this study. Most participants (78.4%) engaged in some form or physical exercise. Fully employed participants (45%) were the largest category in terms of work status. The employed participants were mainly involved in sitting as the most common, or light physical work.

According to the psychosocial factors of work satisfaction, 26.1% rated their work as good and 18% rated their work as great showing that they were satisfied with their work. From this particular study, 36.9% of the participants were at a high risk of chronicity according to the NDI and 37% of the participants were at a high risk of disability according to the yellow flags form. Both these tools results correlate with each other, showing that this percentage of participants is at risk of chronicity and disability. Spearmans correlation shows that a moderate relationship between the NDI and the yellow flags form (risk of chronicity), whereby if the NDI score is high, then the risk of chronicity will also be high. CONCLUSION: The results of this study suggest that one third of the participants with non-specific NP who presented to the DUT CDC were at risk of developing chronic NP.