Associations of low back pain with neck pain

Low back pain (LBP) and neck pain (NP) are common among the adult population but relatively few reports exist on the associations between these. We examined cross-sectional and prospective relationships of LBP with NP in an employee cohort studied repeatedly over 28 years. Locally perceived pain was studied separately from pain with a radiating component. At baseline, adjusted for age, gender, and occupational class, the prevalence ratio (PR) of local NP for those with local LBP was 1.93 (95% CI 1.47-2.54), and for those with radiating LBP 2.16 (1.59-2.94), while the PR of radiating NP for those with local LBP was 1.51 (0.97-2.35) and for those with radiating LBP 3.24 (2.25-4.65). These associations remained stable at the 5-, 10-, and 28-year follow-ups. Both local and radiating LBP at baseline predicted new cases of radiating NP at the 5- and 10-year follow-ups, but not at the 28-year follow-up. In analyses stratified by gender, both the cross-sectional and prospective associations were more pronounced in men. In conclusion, the study showed a clear association of LBP with NP that persisted on a similar level irrespective of the aging of the cohort. Particularly, radiating LBP was associated with radiating NP. The prospective associations of LBP at baseline with new reports of radiating NP decreased as the length of follow-up increased.