Exploring the Causes of Neck Pain and Disability as Perceived by Those Who Experience the Condition: A Mixed-Methods Study

Designing effective treatment protocols for neck-related disability has proven difficult. Disability has been examined from structural, emotional, and cognitive perspectives, with evidence supporting a multidimensional nature. The patient’s perspective of their condition has found increasing value for patient-centred, evidence-informed care. This cross-sectional study utilized descriptive thematic analysis to examine perceptions of causation in 118 people with neck pain. The Brief Illness Perceptions Questionnaire was used to capture perceptions of causation for neck pain symptoms. The Neck Disability Index, the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale, and the P4 pain intensity numeric rating scale were also collected. Eight main themes were found for the cause(s) of neck pain: posture and movement, structure and mechanism, emotions, predisposition and lifestyle, symptoms, fatigue and insomnia, treatment, and environment. A series of regression models stratified by perceived cause suggested that disability could be explained by different constructs across the larger of the main themes. The findings are discussed in terms of the false view that mechanical neck pain should be considered a homogenous condition and potential application to treatment decision making based on patient perspectives.