A Qualitative Description of Chronic Neck Pain has Implications for Outcome Assessment and Classification

Joy C. MacDermid1, 2, *, David M. Walton1, Pavlos Bobos1, Margaret Lomotan1, Lisa Carlesso4
1 School of Physical Therapy, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada
2 Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph’s Health Care London, 268 Grosvenor Street, London, Ontario, N6A 4L6, Canada
3 School of Rehabilitation Sciences, McMaster University, 1400 Main Street West, Hamilton, Ontario, L8S 1C7, Canada
4 Faculty of Medicine, University of Montreal, 2900 Boulevard Edouard-Montpetit, Montréal, QC H3T 1J4, Canada

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© MacDermid et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the School of Physical Therapy, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada; Tel: 519-661-2111; Ext. 88912; E-mail:



Neck pain is common, but few studies have used qualitative methods to describe it.


To describe the quality, distribution and behavior of neck pain.


Sixteen people (15 females; mean age = 33 years (range = 20-69)) with neck pain >3 months were interviewed using a semi-structured guide. Interview data were recorded and transcribed verbatim. Descriptive content analysis was performed by two authors. Participants then completed an electronic descriptive pain tool, placing icons (word and icon descriptors to describe quality) on anatomic diagrams to identify location of pain, and intensity ratings at each location. This data was triangulated with interviews.


Aching pain and stiffness in the posterior neck and shoulder region were the most common pain complaints. All patients reported more than one pain quality. Associated headache was common (11/16 people); but varied in location and pain quality; 13/16 reported upper extremity symptoms. Neuropathic characteristics (burning) or sensory disturbance (numbness/tingling) occurred in some patients, but were less common. Activities that involved lifting/carrying and psychological stress were factors reported as exacerbating pain. Physical activity was valued as essential to function, but also instigated exacerbations. Concordance between the structured pain tool and interviews enhanced trustworthiness of our results. Integrating qualitative findings with a previous classification system derived a 7-axis neck pain classification: source/context, sample subgroup, distribution, duration, episode pattern, pain/symptom severity, disability/participation restriction.


Qualitative assessment and classification should consider the multiple dimensions of neck pain.

Keywords: Classification, Neck pain, Qualitative, Structured pain tool, Thematic analysis, Whiplash.