The increasing prevalence of musculoskeletal disorders in the workplace has been identified as one of the most costly health concerns faced by industrialized nations. Epidemiologic studies suggest that both physical and psychosocial factors play a critical role in the development of work-related neck pain, yet interactions among these risk factors remain poorly understood. The underlying cause of chronic neck pain remains undiagnosed for the majority of cases, likely resulting in suboptimal treatment for many individual patients. The overall goal of this project is to assess the validity of a new screening protocol to identify stress-evoked muscle activity that may either cause or exacerbate neck pain in susceptible individuals.
Aim 1 will use a case- control study design to assess the discriminant and concurrent validity of a standardized screening protocol to detect elevated psychomotor responses to stress in subjects with and without chronic neck pain.
Aim 2 will use a prospective study design to determine the predictive validity of this screening protocol by assessing the risk of developing chronic neck pain in asymptomatic office workers during the first year of employment in a high-risk occupation.
This aim will also determine the diagnostic cutoff score for stress-evoked muscle activity that best predicts the future development of chronic neck pain. Findings from this project will inform the design of future clinical trials by providing a validated tool to identify subgroups of individuals that are most likely to benefit from stress-management interventions to prevent or treat chronic neck pain, which will ultimately improve clinical decision-making for practitioners who treat this disorder. This project will also provide new information on modifiable physical and psychosocial risk factors for chronic neck pain, consistent with research priorities outlined by a multidisciplinary task force of experts in the field.

Public Health Relevance

The Bone and Joint Decade Task Force on Neck Pain recently recognized a need for studies to identify clinicalsubgroups of patients that are most likely to respond to specific types of treatment. This Task Force furtheremphasized the need to better understand how psychosocial and physical exposures at work interact witheach other to cause neck pain; and to identify modifiable risk factors to prevent the development of neck pain.This project will develop and test a new clinical tool to screen for elevated muscle activity in response to stress.This information will be used in future clinical trials to determine whether stress-management interventions canbe used to reduce excessive muscle activity that either causes or exacerbates neck pain in susceptibleindividuals.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
7R01AR056704-05
Application #
8920851
Study Section
Musculoskeletal Rehabilitation Sciences Study Section (MRS)
Program Officer
Serrate-Sztein, Susana
Project Start
2010-07-01
Project End
2015-06-30
Budget Start
2014-08-14
Budget End
2015-06-30
Support Year
Fiscal Year
2014
Total Cost
$100,869
Indirect Cost
$33,623
Name
San Diego State University
Department
Nutrition
Type
Schools of Allied Health Profes
DUNS #
073371346
City
San Diego
State
CA
Country
United States
Zip Code
92182
Kittelson, Andrew J; George, Steven Z; Maluf, Katrina S et al. (2014) Future directions in painful knee osteoarthritis: harnessing complexity in a heterogeneous population. Phys Ther 94:422-32
Marker, Ryan J; Stephenson, Jennifer L; Kluger, Benzi M et al. (2014) Modulation of intracortical inhibition in response to acute psychosocial stress is impaired among individuals with chronic neck pain. J Psychosom Res 76:249-56
Balter, Jaclyn E; Molner, Jennifer L; Kohrt, Wendy M et al. (2013) Mechanical pain sensitivity and the severity of chronic neck pain and disability are not modulated across the menstrual cycle. J Pain 14:1450-9
Shahidi, Bahar; Haight, Ashley; Maluf, Katrina (2013) Differential effects of mental concentration and acute psychosocial stress on cervical muscle activity and posture. J Electromyogr Kinesiol 23:1082-9