• Cees J Vos, Arianne P Verhagen, Jan Passchier, and Bart W Koes.
• Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands. c.vos@erasmusmc.nl
• Pain Med. 2008 Jul 1;9(5):572-80.

ObjectiveTo describe the natural course of patients with acute neck pain presenting in general practice and to identify prognostic factors for recovery and sick leave.DesignWe conducted a prospective cohort study with a 1-year follow-up in general practice. Questionnaires were collected at baseline and after 6, 12, 26, and 52 weeks. Days of sick leave were dichotomized into two groups: below and above 7 days of sick leave. Logistic regression was used to identify prognostic factors for recovery and sick leave.PatientsConsecutive patients with nonspecific neck pain lasting no longer than 6 weeks were invited to participate.ResultsOne hundred eighty-seven patients were included and 138 (74%) provided follow-up data. After 1 year, 76% of the patients stated to be fully recovered or much improved, although 47% reported to have ongoing neck pain. Almost half of the patients on sick leave at baseline returned to work within 7 days. Multivariate analysis showed that the highest association with recovery was the advice of the general practitioner (GP) "to wait and see" (odds ratio [OR] 6.7, 95% confidence interval [CI] 1.6-31.8). For sick leave, referral by the GP, for physical therapy or to a medical specialist, showed the highest association (OR 2.8, 95% CI 1.0-8.4).ConclusionAcute neck pain had a good prognosis for the majority of patients, but still a relatively high proportion of patients reported neck pain after 1-year follow-up. The advice given by the GP "to wait and see" was associated with recovery, and "referral" was associated with prolonged sick leave.

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