Intractable neck pain.

Abstract

A retrospective survey of 1,661 patients seen over a 10-year period at a pain clinic yielded 55 patients with intractable neck pain as the presenting complaint. In 89% there was an industrial or motor vehicle accident as the precipitating event, 78% were involved in legal proceedings relating to the accident, and in 87% the pain radiated to neighboring structures. Diagnostically, 36% had no physical signs, and cervical radiographs were normal for 46%. There was a high incidence of previous psychiatric treatment (53%) and major intrafamily problems (60%). Treatment mainly by psychotherapy or tricyclic antidepressants resulted in some benefit for 56% of patients. Legal compensation and change in occupation were not major factors influencing the outcome of treatment.