Visceral origin: an underestimated source of neck pain

Abstract

The diagnosis of neck pain is challenging. Many visceral disorders are known tocause it, and clinical practice guidelines recommend to rule them out during neck pain diagnosis.However, the absence of suspicion of any cause impedes one from establishing that specific aetiology asthe final diagnosis. To investigate the degree of consideration given to visceral aetiology, a systematicsearch of trials about neck pain was carried out to evaluate their selection criteria. The search yielded309 eligible articles, which were screened by two independent reviewers. The PEDro scale score wasused to assess the methodological quality of the studies. The following information was retrieved:number of authors affiliated to a clinical or non-clinical institution, number of citations in the Webof Science, study aims, characteristics of participants, and eligibility criteria. The top 15 most citedtrials, and the 15 most recent studies about treatment efficacy in neck pain, published in first quartilejournals of the Journal Citation Reports, were selected. Females represented 67.5% of participants.A single study was of poor methodological quality (4/10). Based on the eligibility criteria of thearticles that were systematically reviewed, it would appear that visceral aetiology was not consideredin eighty percent of the trials on neck pain, showing a low level of suspicion both in research andclinical settings.