Neck pain is defined as "pain in the neck with or without discomfort transferred into one or both upper limbs that lasts for at least one day" in the Global Burden of Health 2010 Study. Neck pain is a common occurrence all over the world and is extremely detrimental to both health and the economy. The anguish and incapacitating effects of neck pain have a substantial impact on sufferers, their families, communities, healthcare systems and businesses. Over half of all people will experience a neck ache episode that is clinically serious at some point in their lives [1,2].

Neck pain is also referred to as cervical pain. Risk factors for neck discomfort include genetics, psychopathology (such as depression, anxiety, insufficient coping strategies and somatization), sleep difficulties, smoking and a sedentary lifestyle. Particular risk factors for neck pain include trauma (including whiplash and traumatic brain injuries) and certain sports injuries (eg, wrestling, ice hockey, football). Although some studies have indicated that certain occupations, such as office and computer workers, manual labourers and those in the health care industry, have a higher incidence of neck pain, the primary workplace factors linked to the condition are low job satisfaction and a perceived unfavourable work environment [1,3].

The symptom of dull pain frequently includes neck pain as well. Sometimes, neck pain can get worse when the neck is moved or the head is turned. Additional symptoms related to various types of neck pain include numbness, tingling, discomfort, acute shooting pain, range-of-motion problems, fullness, difficulty swallowing, pulsations, swishing noises in the head, vertigo or lightheadedness and lymph node (gland) enlargement [4,5].

With at-home care, the majority of neck aches improve gradually. It is crucial to consult a doctor if neck pain is severe, persists for several days without relief, spreads to the arms or legs, or is accompanied by headache, numbness, weakness, or tingling [6,7].

In Himachal Pradesh, there aren't many studies that look at people's overall perceptions of neck pain. Therefore, the goal of this study is to determine how knowledgeable the people living in high hilly area of Himachal Pradesh are about the risks and defenses against neck discomfort.

Objectives of the Study

To evaluate the knowledge of patients attending Ortho OPD at Regional Hospital, Keylong in District Lahaul and Spiti of Himachal Pradesh towards risk factors and Preventive measures of neck pain.

• Research Approach: Descriptive

• Research Design: Cross Sectional Hospital Based Survey

• Setting of the Study: Ortho OPD of Regional Hospital, Keylong in District Lahaul and Spiti of Himachal Pradesh

• Study Duration: July 2022 to September 2022

• Study Population: Ortho OPD patients in Regional Hospital, Keylong in District Lahaul and Spiti of Himachal Pradesh

• Sample Size: 400 assuming 50% adults have adequate knowledge of risk and preventive factors for neck pain, 5% absolute error, 95% confidence level and 5% non-response rate

• Sampling Technique: Convenience Sampling Technique

• Sampling Criteria: First five patients attending the Ortho OPD of Regional Hospital, Keylong 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 Regional Hospital, Keylong

• Data collection by the researcher themselves and patients were given 5 minutes’ time to complete that questionnaire and collected at the end of the prescribed time

• Data Analysis: Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analysed with Epi Info V7 Software with appropriate statistical test in terms of frequencies, percentage, mean standard deviation etc

• Ethical Considerations: Participants confidentiality and anonymity was maintained

The goal of the current study was to assess knowledge of neck pain (Cervical Spondilitis) risk factors and preventative methods at at Regional Hospital, Keylong in District Lahaul and Spiti of Himachal Pradesh. In the present study 35.5% (142) of the Patients fall were below 40 years of age while 64.5% (258) were above 40 years. 58.75% (235) of patients were male and 41.25% (165) were female (Table 1).

Table 1: Knowledge about Risk Factors of Neck Pain

Among the total study participants, 37 (9.25%%) didn’t know about any risk factor of neck pain. 319 (79.75%) 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 298 (74.5%), Bad posture while sitting, walking and during sleep 212 (53%), Over use of computer or smart phone 210 (52.5%), Carrying heavy bags on Head/shoulder 198 (49.5%), Lack of physical activity/exercise 112 (28%), Inadequate amounts of dietary calcium and vitamin D intake 84 (21%).

Driving or traveling long distances 83 (20.75%), Overweight/Obesity 75 (18.75%), Unhealthy diet 35 (8.75%), Neck muscle strain/injury/stress 28 (7%), Nerve compression 22 (5.5%) and Neck Muscle weakness 20 (5%) (Table 2).

Table 2: knowledge of Patients towards Prevention of Neck Pain

Among the total , maximum 312 (78%) 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 305 (76.25%), Using a soft pillow during sleeping 297 (74.25%), Adjusting the desk, chair and computer while studying/reading 220 (55%), Sitting straight in chair with neck and back support while studying/reading properly 219 (54.75%), Frequent breaks while working on computer/mobile 213 (53.25%), Avoid heavy lifting on head/shoulder 210 (52.5%), Using a headset or speakerphone rather than cradling the phone on shoulder when talking on the phone 203 (50.75%), Exercise of neck and yoga regularly 113 (28.25%), Calcium and Vitamin D supplements 83 (20.75%), Frequent breaks while travelling long distances 82 (20.5%), Maintaining ideal weight 75 (18.75%), Eat healthily and balanced diet 36 (9%) and Avoiding neck injury/sprain 32 (8%). Still 31 (7.75%) respondents didn’t know any preventive factor for shoulder pain among participants.

Neck discomfort is a frequent problem that can be caused by a variety of medical conditions. It can range from mild to severe and more serious cases might indicate a serious underlying problem. Mild to moderate neck pain is often treatable at home and becomes better in a couple of weeks [6,8].

Stretching, massage therapy, chiropractic adjustments, applying heat or ice to the neck at home, taking over-the-counter or prescription medicines and all of these can be utilised to relieve acute neck discomfort. However, if someone suddenly experiences severe neck pain as a result of an injury, such as following a fall or a car accident, it's imperative to seek immediate medical attention. One should consult a physician if they are experiencing numbness, weakness, or a shooting pain down their arm in addition to neck discomfort. Some of the aforementioned therapies are successful in treating persistent neck pain. However, surgery may occasionally be required to treat the specific illnesses causing neck pain [9-11].

In current study, 37 (9.25%) of the total study participants were unaware of any risk factors for neck pain. Bad posture while using a computer, mobile device, or while reading, according to 319 respondents (79.75%), is the main risk factor for neck pain, followed by using a hard pillow while you sleep, according to 298 respondents (74.5%) and using a computer or mobile device excessively, according to 212 respondents (53%). The majority of survey participants, 312 (78%) said that changing positions frequently and stretching the neck muscles while working are the main preventive factors for neck pain. These factors are followed by maintaining good posture while sitting, walking and sleeping 305 (76.25%) and using a soft pillow while sleeping 297 (74.25%). Still, 31 (7.75%) respondents said they were unaware of any factors that might avoid shoulder pain in participants.

It is advantageous to maintain neutral spinal alignment while seated and when standing up straight and with the shoulders back. You can reduce the strain on your intervertebral discs and ligaments by maintaining good posture throughout the day. Even though not all neck pain can be prevented, keeping your shoulders over your hips and your ears directly above your shoulders will unquestionably assist reduce your likelihood of suffering from neck pain. When sat at a desk, the configuration should be changed such that the computer monitor is at eye level and the knees are just above the hips [12,13].

By sleeping with the head and neck in the right alignment with the rest of the body, neck pain can also be avoided. The Mayo Clinic suggests sleeping on your back with your legs up on cushions to flatten the spinal muscles. Finding the right pillow, mattress and sleeping position could reduce your likelihood of waking up with neck pain. However, because each person is different, it could require some trial and error before figuring out what works best. For instance, the cervical spine is most stressed when lying on the stomach, yet opinions on whether it is better to sleep on the side or the back are mixed. A cervical pillow may also be comfortable for some people, although other people may prefer other pillows [14,15].

The entire body, including the neck, is kept relatively sturdy and flexible by leading an active lifestyle. Additionally, practising daily neck and core-strengthening stretches and exercises may help to enhance posture. Poor posture commonly results in neck strains because of weak neck muscles. When starting a new sport or activity, start slowly and gradually increase the speed or workload. It is common to feel strained in the muscles while doing a new or unfamiliar activity [16,17].

Future occurrences are more likely when the neck is stretched. Additionally, trying to heal a neck strain injury too quickly before it does so risked aggravating it and delaying the healing process. Repetitive motions can cause strained muscles to develop, including neck muscles. While performing various activities, muscles can rest and repair themselves to prevent harm. If you commute a long way or spend a lot of time at a computer, get up, walk around and extend your neck and shoulders to prevent neck pain [16].

Avoid placing the phone or mobile device between your ear and shoulder when talking on the phone or using it. Neck ache is avoided by utilizing a loudspeaker or headset instead. The weight may cause pain in your neck. Another way to avoid neck strain is to avoid carrying large bags with straps over your shoulder [18].

The results of the study showed that the participants' knowledge of neck discomfort was either poor or unsatisfactory. Neck pain can be prevented by adjusting the computer, chair and desk when reading or studying while correctly reading or studying while seated straight in a chair with support for the neck and back, regular breaks while using a computer or mobile device, stretching neck muscles, ensuring proper posture when standing, sitting and walking, using a soft cushion while sleeping, Avoid straining your shoulders or head, Use a headset or speakerphone when talking on the phone rather than resting it on your shoulder, regular neck and yoga practice, vitamin D and calcium supplements, frequent pauses while travelling long distances and maintaining a healthy weight. The current study supports educational initiatives and public awareness campaigns about the causes, symptoms and preventative strategies of neck pain.

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