Frequencies of persistence, activity pacing, fear avoidance and general stress in acute neck pain

Abstract

Background

Neck pain (NP) is a common musculoskeletal health problem, persisting in 47 % of cases. A person's engagement in daily activities is defined as activity patterns (eustress persistence, distress persistence, activity pacing, and fear avoidance) that influence the development and continuation of pain. These behaviors may be linked to heightened stress levels, further negatively impacting pain perception. Understanding these relationships is vital, given the intricate interplay between stress, pain, and activity patterns. This study aims to assess the frequency of activity patterns and identify their impact on stress levels in participants with acute NP.

Methods

125 individuals aged 18–65 with acute NP were recruited. Activity patterns were identified using the Avoidance-Endurance Fast Screen, which calculated the frequencies of activity patterns. Furthermore, subjective stress was evaluated using the Stress and Coping Inventory and objective stress using hair cortisol concentration to determine which activity pattern group experienced the highest stress.

Results

Most participants were classified in the eustress persistence group (52 %), followed by activity pacing (22.8 %), distress persistence (19.5 %), and fear avoidance (5.7 %). Subjective and objective stress levels consistently remained below established reference values. Analysis of activity pattern groups showed that distress persistence had the highest subjective stress levels, followed by fear avoidance, while activity pacing had the lowest. No relevant differences between the activity pattern groups were observed in the objective stress measurements.

Discussion

To the best of our knowledge, this study represents the first investigation of frequencies of activity patterns and subjective and objective stress in acute NP.