The cause of neck pain is not just physical, doctors in Germany have shown. They say that psychological distress - particularly depression and anxiety - are closely linked to persistent neck pain.

When people with neck pain seek treatment, Dr. Martin Scherer told Reuters Health, “for successful long-term results, it is essential to consider psychosocial factors and to include them into therapeutic strategies.”

Scherer, at the University of Gottingen, and his associated studied 448 patients in Germany who had suffered at least one episode of neck pain. More than half of the subjects (56 percent) reported neck pain on the day they completed the questionnaire and 26 percent had constant neck pain during the past year.

Based on their responses to a standard assessment questionnaire, 20 percent of subjects were classified as having depressive mood, and 28 percent were found to be anxious, the investigators report in the journal BMC Musculoskeletal Disorders.

According to Scherer and colleagues, individuals with depressive mood or anxiety were highly likely to have the highest levels of neck pain.

The results, the researchers say, suggest that the degree of neck pain is related to the degree of psychological distress. “To put it in other words,” they write, “the higher the pain level in patients with (neck) problems, the more attention should be paid to psychosocial distress as an additional burden.”

The findings, Scherer told Reuters Health, “underline that neck pain therapies are more likely to be (effective) if care for chronic patients is not only symptom-oriented but focuses on psychosocial factors that have been proved to be central for development and prognosis of neck pain.”

SOURCE: BMC Musculoskeletal Disorders, online January 26, 2009.