CORRELATION OF PAIN INTENSITY WITH DISABILITY IN PATIENTS WITH CHRONIC NECK PAIN: A SRI LANKAN STUDY

Abstract

Chronic neck pain, a known health problem in the modern society has a direct impact on disability in daily life, work absenteeism and health-care cost. Though the pain is interrelated with disability, the relationship between pain intensity and disability is not fully understood. The aim of this study was to investigate the relationship between pain intensity and the disability. This descriptive cross sectional study was carried out with a sample of 112 (male 27 and female 85) chronic (more than 3 months duration) neck pain patients aged between 20 and 70 years attending the Rheumatology clinic at the Colombo South Teaching Hospital and National Hospital Sri Lanka. Informed consent was obtained from patients. Data were collected by using an interviewer administered questionnaire. Pain intensity was measured by a visual analog scale (VAS) – 0 mm (no pain) to 100mm (worst possible pain). Neck Disability Index questionnaire, a modification of the Oswestry Low Back Pain Disability Index was used to assess the functional disability of the patients. To determine the relationship between pain intensity and disability, Spearman’s correlation coefficient was used. In this study, 90% patients were above 40 years of age. Neck pain intensity was categorized as mild (1–25), moderate (26–50), severe (51-75) and worst possible pain (76–100). Percentage 50 of the patients (56/112) graded the pain to be worst possible and 41.1% (46/112) graded the pain as severe. Neck disability degree was interpreted as mild (0%–20%), moderate (21%–40%), severe (41%–60%), disabling (61%–80%) and severely disabling (81%–100%). Percentage 79.5 of the patients (89/112) had severe neck disability. A significant relationship between neck pain intensity and disability (p-value= 0.000) was seen. A positive and a moderate association between neck pain intensity and disability was evident. The findings were compatible with published previous studies where a moderate, but a strong association between neck pain intensity and disability has been reported. Pain intensity is a strong indicator of disability. These results have implications for future clinical and epidemiological studies.