Are weight and leisure physical activity associated with the onset or the chronicity of neck pain in adults with non specific neck pain? A systematic review

Objective: To synthesize evidence from the past decade on the association between weight, leisure physical activity (PA), and the onset or chronicity of neck pain in adults with non-specific neck pain (NSNP). Literature search: Five databases (PubMed, Scopus, Embase, Cochrane Library, PsycINFO) were searched from January 2010 to November 2021. Study selection criteria: Case-control or cohort studies assessing the association between the onset or the chronicity of NSNP, weight and leisure PA in healthy adults or adults with NSNP at baseline. Data synthesis: Use of the “vote counting based on direction of effects” and narrative synthesis. Results: Nine articles were included (20,350 participants, range 86-11,391), four on the onset and five on the chronicity of NSNP. Methodological quality varied from poor to good according to the Newcastle-Ottawa Scale. For the onset and the chronicity of NSNP, studies showed modest associations suggesting a decreased risk with higher levels of leisure PA and an increased risk in overweight and obese people. However, certainty of evidence was judged to be very low for each association. Conclusion: The findings showed modest and sometimes inconsistent associations, but overall suggest that the risk of NSNP (onset and chronicity) may be decreased in more active people and increased in overweight and obese people. Results should be interpreted with caution and should not be generalized to populations other than white-collar workers. Future studies are needed to provide stronger evidence on these associations and to investigate the impact of combined factors (e.g., a healthy lifestyle) on NSNP