Factors Associated with Time Interval Between Neck Pain Recurrences -A Nationwide Longitudinal Study-

Purpose: This study aimed to investigate factors associated with changes in the interval between consecutive episodes of neck pain using the National Health Insurance Service health screening cohort of South Korea.Methods: This retrospective study included 741,010 individuals from the National Health Insurance Service health screening cohort data set.The interval between consecutive episodes of neck pain was used as the primary outcome, and interval prolongation was defined as a longer symptom-free period compared with the preceding interval.Demographic, socioeconomic, physical activity, and disease-related variables were included.A random-effects logistic regression model was used to identify factors associated with interval prolongation.Results: Younger age, higher insurance level, vigorous physical activity, and a greater number of episodes were associated with a higher likelihood of interval prolongation.In contrast, hospital admission, longer length of stay, higher body mass index, moderate physical activity, and walking frequency were associated with a lower likelihood of interval prolongation.Insurance type and regional health percentile were also significantly associated with interval prolongation. Conclusion:Interval prolongation in recurrent neck pain is associated with demographic, socioeconomic, behavioral, and disease-related factors.These findings suggest that both clinical and socioeconomic factors should be considered in the management of recurrent neck pain.