The Multidimensionality of Chronic Non-Specific Neck-Shoulder Pain : Investigated in a Longitudinal Intervention Study Based on Questionnaires and Clinical Tests

The present study, based on a battery of instruments measuring pain in different dimensions, covering neurophysiological, psychological, functional and health-related domains, investigated chronic non-specific neck-shoulder pain as a multidimensional phenomenon of pain. Applications to the gate control theory of pain and the fear-avoidance model were examined and discussed. The participants were Swedish women, 25-65 years of age with chronic non-specific neck-shoulder pain (NS) and age-matched healthy controls (CON), n =117 and n = 33 respectively. The study was a randomized controlled mixed design with three different interventions (strength training, neck coordination training and massage). Baseline testing were assessed followed by interventions for 11 weeks and subsequent post-tests, 6-months- and 12-months- follow-up tests. The results demonstrated significant differences between the NS group and the CON group in muscle tenderness, psychological well-being, depression and health-related quality of life before intervention. No significant differences were revealed in analyses in neck disability or depression taking level of kinesiophobia and active versus passive treatment into account. This lack of unambiguous support to the fear avoidance model demonstrates the complexity between these dimensions and call for further investigations. Taken together, the results of the present study support the multidimensionality of pain in the NS participants and implicate that the fear-avoidance model and the gate control theory of pain may provide some explanation to these aspects. Keywords: chronic non-specific neck-shoulder pain, multidimensional pain, kinesiophobia, catastrophizing, health, depressio