It’s estimated that about 1 in 6 American adults experience neck pain in a given three-month time frame. Neck pain is a major cause of work absenteeism, work-related injury, and reduced quality of life. While some risk factors for neck pain may be unavoidable, many are not.

A systematic review completed by a team of authors from the Department of Orthopedics at Duke University concluded that work requiring sustained and/or awkward postures was the most important physical risk factor for neck pain. Several recent studies have demonstrated that taking frequent breaks to reduce sitting time (especially when performing short bouts of exercise) can mitigate much of this risk, as can improving sitting posture and workstation ergonomics—especially raising the monitor height so that users do not need to look downward at a screen.

However, the Duke University team found that psychosocial risk factors may be just as, if not more, important in the development of neck pain. These psychosocial factors include depressed mood, job stress, and perceived muscular tension.

The review also looked at factors that may reduce the risk for a first-time episode of neck pain transitioning into chronic or persistent neck pain, and it identified the following protective factors: supportive work and social environment; leisure physical activity; and strong cervical extensor muscle endurance (strength).

Prior studies have reported on the presence of both psychosocial factors as well as weak neck muscles in patients suffering with chronic neck pain, especially weakness of the deep neck flexor muscles. Hence, it comes as no surprise that the same two factors that were identified by the Duke University team as being important risk factors for FIRST time neck pain onset are also prevalent in chronic neck pain patients.

For the management of neck pain, treatment guidelines generally recommend a multimodal, conservative approach that includes manual therapies (such as mobilization and manipulation performed by a doctor of chiropractic), neck-specific exercises, and instruction on dietary choices (especially avoiding inflammation-promoting foods), stress relief/relaxation techniques, and improving sleep quality, as these not only aid in the healing process but also in reducing the risk for neck pain recurrence.