Different trajectories for people with acute neck pain: associations with biological, psychosocial and treatment-related factors.

Preventing persistence of non-specific neck pain will help to reduce the total burden of neck pain. Acute neck pain can be considered as a complex condition and several biological- and psychosocial factors interact bi-directionally and affect recovery. Currently, we are unable to predict who will recover and detailed information about the clinical course of people with acute neck pain is lacking. Recent insights show that the level of systemic inflammation and various psychosocial factors differ between recovered and non-recovered patients. Since the clinical course of people with acute neck pain is heterogeneous, it is important to identify different trajectories, and explore which biological-, psychosocial and treatment related factors are associated with recovery, and are different compared to non-recovery.

We hypothesize that there will be different trajectories related to recovery in acute neck pain patients and that several biological, psychosocial and treatment related factors are associated with distinct trajectories. We hypothesize that the recovery trajectory will be associated with an early robust inflammatory response with intact cortisol awakening response (CAR). The non-recovery trajectory will be associated with ongoing inflammatory responses, a reduced CAR and more psychosocial discomfort compared to the recovery trajectory. In the current study we will use advances in biomedical and psychosocial assessment techniques to explore a range of characteristics from patients with acute neck pain. This exploratory study builds further on very recent developments within pain science and can lead to a subsequent study with more participants.

All inflammatory markers, clinical characteristics and psychosocial assessments will be performed at baseline (T0), two weeks evaluation (T1), four weeks evaluation (T2), six weeks evaluation (T3), three months evaluation (T4) and six months evaluation (T5).

Participants will not receive any treatment in the context of the present study. However, they are free to consume usual care conservative treatment such as physiotherapy or general practitioner care or self care. The number and modality of treatments will be recorded. We are interested in the different trajectories in the clinical course of people with neck pain. If the patients fits the inclusion/exclusion criteria the participant is eligible with or without treatment.