The Global Burden of Health 2010 Study describes neck pain as "pain in the neck with or without pain transferred into one or both upper limbs that lasts for at least one day." Around the world, neck pain is a widespread occurrence and has a significant negative impact on health and the economy. Neck pain sufferers, their families, communities, healthcare systems, and enterprises are all significantly impacted by the agony and incapacity it causes. Over the course of their lives, over half of all people will suffer a clinically significant episode of neck discomfort [1,2].

Cervical pain is another name for neck pain. Genetics, psychopathology (such as depression, anxiety, inadequate coping mechanisms, and somatization), sleep disorders, smoking, and sedentary lifestyle are all risk factors for neck discomfort. A history of neck discomfort, trauma (such as whiplash and traumatic brain injuries), and certain sports injuries are particular risk factors for neck pain (eg, wrestling, ice hockey, football). While some studies have shown that certain professions, such as office and computer workers, manual labourers, and those in the health care industry, have a higher incidence of neck pain, the main workplace factors linked to the condition are low job satisfaction and a perceived unfavourable work environment [1,3].

In many cases, dull hurting is accompanied by neck ache as a symptom. Moving the neck or twisting the head might occasionally make neck pain worse. Numbness, tingling, discomfort, acute shooting pain, range-of-motion issues, fullness, difficulty swallowing, pulsations, swishing noises in the head, vertigo or lightheadedness, and lymph node (gland) swelling are additional symptoms connected to various types of neck pain [4,5].

The majority of neck pains get better gradually with at-home care. When neck discomfort is severe, lasts for several days without relief, spreads to the arms or legs, or is accompanied by headache, numbness, weakness, or tingling, it is vital to see a doctor [6,7].

There aren't many researches in Himachal Pradesh that examine people's general understanding about concerning neck discomfort. Therefore, the purpose of this study is to ascertain how well-informed the population of Himachal Pradesh is regarding risk factors and preventive measures for neck discomfort.

Objectives Of the Study

To evaluate the knowledge of patients attending Ortho OPD in Zonal Hospital Dharamshala in Himachal Pradesh towards risk factors and Preventive measures of neck pain.

Research Approach

Descriptive

Research Design

Descriptive survey design

Setting of the Study

Ortho OPD of Zonal Hospital Dharamshala in Himachal Pradesh

Study Duration

August 2018 and October 2019

Study Population

Ortho OPD patients in Zonal Hospital Dharamshala in Himachal Pradesh.

Sample Size

400 Ortho OPD patients

Sampling Technique

Convenience Sampling Technique

Sampling Criteria

First five patients attending the Ortho OPD of Zonal Hospital Dharamshala everyday were selected till the completion of sample size after explaining the purpose of the study. Informed consent/assent was taken from them and confidentiality of the selected participants was also maintained 

Inclusive Criteria

Patients selected during the day of data collection in study setting and who were willing to participate in the study.

Exclusion Criteria

Patients who were not willing to participate in the study 

Development of Tool-Knowledge related questionnaires

Description of Tool

Section A: 

Socio-demographic characteristics of the patients (Age, Gender etc.).

Sections B: 

Questions regarding knowledge of risk and preventive factors for neck pain 

Validity of Tool 

By the experts in this field

Permission

Obtained from the concerned head of the civil hospital

Data Collection 

By myself and patients was given 5 minutes time to complete that questionnaire and collected at the end of the prescribed time

Data Analysis 

With appropriate statistical test in terms of frequencies and percentage.

The goal of the current study was to assess knowledge of neck pain risk factors and preventative methods at the Zonal Hospital Dharamshala in Himachal Pradesh. In the present study 37% (148) of the Patients fall were below 40 years of age while 63% (252) were above 40 years. 59.25% (237) of patients were male and 40.75% (163) were female (Table 1).

Table 1: Knowledge about risk factors of Neck Pain

Among the total study participants, 39 (9.75%%) didn’t know about any risk factor of neck pain. 336 (84%) respondents told that Bad posture while working on computer/mobile/reading is the major risk factor for neck pain followed by Hard pillow during sleep 314 (78.5%), Bad posture while sitting, walking & during sleep 223 (55.75%), Over use of  computer or smart phone 221 (55.25%), Carrying heavy bags on  Head/shoulder 208 (52%), Lack of physical activity/ exercise 118 (29.5%), Inadequate amounts of dietary calcium and vitamin D intake 88 (22%), Driving or traveling long distances 87 (21.75%), Overweight/ Obesity 79 (19.75%), Unhealthy diet 37 (9.25%), Neck muscle strain /injury/stress 29 (7.25%), Nerve compression  23 (5.75%) and  Neck Muscle weakness 21 (5.25%) (Table 2).

Table 2: knowledge of patients towards Prevention of Neck Pain

Among the total , maximum 328 (82%)respondents told that the Frequent position change and stretching the neck muscles while working is the major preventive factor for neck  pain followed by Maintaining good posture while sitting, walking and sleeping 321 (80.25%), Using a soft pillow during sleeping 313 (78.25%) ,Adjusting the desk, chair and computer while studying/reading  232 (58%), Sitting straight in chair with neck and back support while studying/reading properly 230 (57.5%), Frequent breaks while working on computer/mobile 224 (56%), Avoid heavy lifting on head/shoulder 221 (55.25%), Using a headset or speakerphone rather than cradling the phone on shoulder when talking on the phone 214 (53.5%),Exercise of neck & yoga regularly 119 (29.75%), Calcium and Vitamin D supplements 87 (21.75%), Frequent breaks  while   travelling  long distances 86 (21.5%), Maintaining ideal weight 79 (19.75%), Eat healthily and balanced diet 38 (9.5%) and Avoiding neck injury/sprain 34 (8.5%). Still 33 (8.25%) respondents didn’t know any preventive factor for shoulder pain among participants.

Many different medical disorders can result in neck pain, which is a common complaint. It can be mild to severe, and more severe cases may point to a major underlying issue. Neck discomfort that is mild to severe may typically be treated at home and becomes better in a couple of weeks [6,8]. Applying heat or ice to the neck at home, taking over-the-counter or prescription painkillers, getting massage therapy or chiropractic adjustments, or stretching can all be used to alleviate acute neck discomfort. However, it's crucial to get prompt medical help if someone suddenly has significant neck discomfort as a result of an injury, such as after a fall or a vehicle accident. In addition to neck discomfort, one should see a doctor if they are also feeling numbness, weakness, or a shooting pain down their arm in addition to their neck ache. Some of the aforementioned treatments are effective for treating chronic neck discomfort. But occasionally, surgery is necessary to treat the particular diseases causing neck pain [9-11].

In the present study, among the total study participants, 39 (9.75%%) didn’t know about any risk factor of neck pain. 336(84%) respondents told that Bad posture while working on computer/mobile/reading is the major risk factor for neck pain followed by Hard pillow during sleep 314(78.5%), Bad posture while sitting, walking and during sleep 223(55.75%) and Over use of computer or smart phone 221 (55.25%). Among the total , maximum 328(82%)respondents told that the Frequent position change and stretching the neck muscles while working is the major preventive factor for neck pain followed by Maintaining good posture while sitting, walking and sleeping 321 (80.25%), Using a soft pillow during sleeping 313(78.25%) and Adjusting the desk, chair and computer while studying/reading  232(58%).Still 33(8.25%) respondents didn’t know any preventive factor for shoulder pain among participants.

Maintaining neutral spinal alignment while sitting and standing up straight and with the shoulders back is beneficial. By keeping proper posture throughout the day, you can lessen the forces that are placed on your intervertebral discs and ligaments. Although not all neck discomfort can be avoided, maintaining proper posture by placing your shoulders over your hips and your ears directly above your shoulders will undoubtedly help lower your risk of experiencing neck pain. When working at a desk, the configuration should be adjusted so that the computer monitor is at eye level and the knees are slightly lower than the hips when the person is seated [12,13].

Neck pain can also be avoided by sleeping with the head and neck in proper alignment with the rest of the body. To flatten the spinal muscles, the Mayo Clinic advises sleeping on your back with your legs raised on cushions. Finding the ideal pillow, mattress, and sleeping posture might lower your chance of experiencing neck pain in the morning. But since every person is unique, it could take some trial and error before finding what works best. For instance, sleeping on the stomach places the greatest strain on the cervical spine, yet opinions on whether sleeping on the side or the back is preferable are divided. Additionally, while some people enjoy a cervical pillow, others might find different pillows to be more comfortable [14,15].

A physically active lifestyle keeps the entire body, including the neck, relatively robust and flexible. Additionally, completing stretches and exercises that focus on the neck and core muscles on a daily basis might assist to improve posture. Due to weak neck muscles, poor posture frequently leads to neck strains. Start at a manageable speed or workload when beginning a new sport or activity, and then progressively increase over time. It is typical to experience muscle strain when engaging in a novel or unfamiliar activity [16,17].

A stretched neck makes it more likely that it may occur again in the future. Additionally, attempting to recover from a neck strain injury too rapidly before it recovers might make the injury worse and add time to the recovery process. Neck muscles, among others, can get strained as a result of repetitive actions. Muscles can rest and recuperate while engaging in different activities to prevent damage. Get up, move around, and extend your neck and shoulders if you commute a long distance or spend a lot of time at your computer to prevent neck pain [16]. When someone is on the phone or a mobile device, avoid nestling the device between your ear and shoulder. Instead, using a speakerphone or headset prevents neck strain. Your neck may become sore from the weight. Neck pain can also be prevented by refraining from carrying hefty bags with straps over the shoulder [18].

According to survey findings, the participants had either insufficient or not satisfactory knowledge about the Neck pain. Changing positions frequently while working, stretching neck muscles ensuring proper posture when standing, sitting, and walking,  utilizing a soft cushion while sleeping, adjusting the computer, chair, and desk when reading or studying while correctly studying or reading while seated straight in a chair with support for the neck and back, regular breaks while using a computer or mobile device, Steer clear of head and shoulder strain, Instead of resting the phone on your shoulder when conversing on the phone, use a headset or speakerphone. frequent neck and yoga practise, vitamin D and calcium supplements, while travelling long distances, frequent breaks keeping the ideal weight 75 (18.75 percent), Eating a balanced, healthy diet and avoiding neck sprains/injuries help to prevent neck pain. The present study warrants the educational program and awareness campaigns on risk factors and Preventive measures of neck pain.

1. Physio-pedia. “Epidemiology of neck pain.” Physio-pedia, May 2022, www.physio-pedia.com/Epidemiology_of_Neck_Pain. Accessed May 2022.

2. CenterWatch. “Comparison of active release technique and post-isometric relaxation technique on pain and functional disability in patients with mechanical neck pain.” CenterWatch, May 2022, www.centerwatch.com/clinical-trials/listings/259704/comparison-of-active-release-technique-and-post-isometric-relaxation-technique-on-pain-and-functional-disability-in-patient-with mechanical-neck-pain. Accessed May 2022.

3. Physio-pedia. “Epidemiology of neck pain.” Physio-pedia, May 2022, www.physio-pedia.com/Epidemiology_of_Neck_Pain. Accessed May 2022.

4. MedicineNet. “Neck pain.” MedicineNet, May 2022, www.medicinenet.com/neck_pain/article.htm. Accessed May 2022.

5. Spine-health. “Neck pain symptoms.” Spine-health, May 2022, www.spine-health.com/conditions/neck-pain/neck-pain-symptoms. Accessed May 2022.

6. Healthline. “Neck Pain.” Healthline, May 2022, www.healthline.com/health/neck-pain. Accessed May 2022.

7. Mayo Clinic. “Neck pain: Symptoms and causes.” Mayo Clinic, May 2022, www.mayoclinic.org/diseases-conditions/neck-pain/symptoms-causes/syc-20375581. Accessed May 2022.

8. Everyday Health. “Neck pain.” Everyday Health, May 2022, www.everydayhealth.com/neck-pain. Accessed May 2022.

9. Medical News Today. “Neck pain.” Medical News Today, May 2022, www.medicalnewstoday.com/articles/321444. Accessed May 2022.

10. Spine-health. “Treatment for neck pain.” Spine-health, May 2022, www.spine-health.com/conditions/neck-pain/treatment-neck-pain. Accessed May 2022.

11. SpineUniverse. “Neck Pain.” SpineUniverse, May 2022, www.spineuniverse.com/conditions/neck-pain. Accessed May 2022.

12. Healthline. “Benefits of good posture.” Healthline, May 2022, www.healthline.com/health/fitness-exercise/posture-benefits. Accessed May 2022.

13. Spine-health. “Posture: How to straighten your back.” Spine-health, May 2022, www.spine-health.com/wellness/ergonomics/posture-straighten-your-back. Accessed May 2022.

14. SpineUniverse. “Sleep positions for back and neck pain.” SpineUniverse, May 2022, www.spineuniverse.com/wellness/sleep/position-yourself-sound-sleep-back-pain. Accessed May 2022.

15. Healthline. “Best Pillow for Neck Pain.” Healthline, May 2022, www.healthline.com/health/neck-pain/best-pillow-for-neck-pain. Accessed May 2022.

16. Spine-health. “Neck strain: Treatment and prevention.” Spine-health, May 2022, www.spine-health.com/conditions/neck-pain/neck-strain-treatments-and-prevention. Accessed May 2022.

17. Physio-pedia. “Principles of exercise.” Physio-pedia, May 2022, www.physio-pedia.com/Principles_of_Exercise. Accessed May 2022.

18. Nexxbar. “Neck pain and tension.” Nexxbar, May 2021, nexxbar.com/blogs/news/neck-pain-and-tension. Accessed May 2022.