Correlation of disability with anxiety and depression in patients with chronic non-specific neck pain: a cross-sectional observational study


  • Dipti B. Geete Physiotherapy School and Centre, Seth G. S. Medical College and K. E. Medical Hospital, Mumbai, Maharashtra, India
  • Bhavana S. Mhatre Physiotherapy School and Centre, Seth G. S. Medical College and K. E. Medical Hospital, Mumbai, Maharashtra, India
  • Saraswati Iyer Physiotherapy School and Centre, Seth G. S. Medical College and K. E. Medical Hospital, Mumbai, Maharashtra, India



Chronic Non-specific, Neck pain, Anxiety, Depression


Background: Neck Pain is a prevalent musculoskeletal condition usually associated with disability. Psychological illnesses like anxiety and depression are commonly seen in chronic pain. The purpose of this study was to evaluate the relationship between anxiety, and depression with disability in patients with chronic non-specific neck pain.

Methods: 87 patients with chronic non-specific neck pain were recruited in this cross-sectional study. The disability was evaluated with neck disability index, anxiety with the generalized anxiety disorder scale (GAD-7), and depression with patient health questionnaire (PHQ9).

Results: Out of 87, 60 were females and 27 were male. For correlation, Spearman’s test was applied for the outcome measures. There was a moderate positive correlation found between disability and anxiety (r=0.55) and between neck pain and depression (r=0.63).

Conclusions: There is a moderate positive correlation between self-reported disability and anxiety (GAD7) and also between self-reported disability and depression (PHQ9) in patients with chronic non-specific neck pain.



Liu F, Fang T, Zhou F, Zhao M, Chen M, You J, et al. Association of depression/anxiety symptoms with neck pain: a systematic review and meta-analysis of literature in China. Pain Res Manage. 2018.

Hurwitz EL, Randhawa K, Yu H, Côté P, Haldeman S. The global spine care initiative: a summary of the global burden of low back and neck pain studies. Eur Spine J. 2018;27(6):796-801.

Disease and injury incidence and prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789-858.

Guzman J, Hurwitz EL, Carroll LJ, Haldeman S, Côté P, Carragee EJ, et al. A new conceptual model of neck pain. Eur Spine J. 2008;17(4):14-23.

Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. press. 2020;161(9):1976-82.

Meints SM, Edwards RR. Evaluating psychosocial contributions to chronic pain outcomes. Prog Neuropsychopharmacol Biol Psychiat. 2018;87:168-82.

Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med. 2003;163:2433-45.

Asmundson GJ, Katz J. Understanding the co-occurrence of anxiety disorders and chronic pain: state-of-the-art. Depress Anxiety. 2009;26:888-901.

Kuringe E, Materu J, Nyato D, Majani E, Ngeni F, Shao A, et al. Prevalence and correlates of depression and anxiety symptoms among out-of-school adolescent girls and young women in Tanzania: a cross-sectional study. PLoS One. 2019; 14(8):e0221053.

Deady M, Choi I, Calvo RA, Glozier N, Christensen H, Harvey SB. eHealth interventions for the prevention of depression and anxiety in the general population: a systematic review and metaanalysis. BMC Psychiat. 2017;17(1):1-4.

Blozik E, Laptinskaya D, Herrmann-Lingen C, Schaefer H, Kochen MM, Himmel W, et al. Depression and anxiety as major determinants of neck pain: a cross-sectional study in general practice. BMC Musculoskelet Disord. 2009;10:13.

Kim T, Kang MY, Yoo MS, Lee D, Hong YC. Computer use at work is associated with self-reported depressive and anxiety disorder. Ann Occup Environ Med. 2016;28(1):1-8.

Daliri BO M, Khorasani HM, Olia ND, Azhari A, Shakeri M, Moradi A. Association of psychological factors with limb disability in patients with cervical radiculopathy: comparison with carpal tunnel syndrome. BMC Musculoskeletal Disord. 2022;23(1):1-9.

Wenzel HG, Haug TT, Mykletun A, Dahl AA. A population study of anxiety and depression among persons who report whiplash traumas. J Psychosomat Res. 2002;53(3):831-5.

Ranger TA, Cicuttini FM, Jensen TS, Manniche C, Heritier S, Urquhart DM. Catastrophization, fear of movement, anxiety, and depression are associated with persistent, severe low back pain and disability. Spine J. 2020;20(6):857-65.

Oliveira DS, Mendonça VFL, Sampaio SMR, Castro-Lopes MPJ, Ribeiro-de-Azevedo LF. The impact of anxiety and depression on the outcomes of chronic low back pain multidisciplinary pain management-A multicenter prospective cohort study in pain clinics with one-year follow-up. Pain Med. 2019;20(4):736-46.

Kakpovi K, Soedje KM, Koffi-Tessio VE, Ahoble KE, Fianyo E, Houzou P, et al. Anxiety and depression disorders in chronic non-specific low back pain in Lomé (Togo). J Rheumatol Autoimmune Dis. 2017;7(01):1-15.

MacDermid JC, Walton DM, Avery S, Blanchard A, Etruw E, McAlpine C, et al. Measurement properties of the neck disability index: a systematic review. J Orthop Sports Phys Ther. 2009;39(5):400-17.

Rutter LA, Brown TA. Psychometric properties of the generalized anxiety disorder scale-7 (GAD-7) in outpatients with anxiety and mood disorders. J Psychopathol Behav Assess. 2017;39(1):140-6.

Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Int Med. 2006;166(10):1092-7.

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13.

Parikh PR, Amarnath TK. To study the relationship between neck pain and anxiety, depression in computer workers-a correlation study. Int J Health Sci Res. 2021;11(6):356-61.

Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Do psychological states associate with pain and disability in chronic neck pain patients?. J Back Musculoskelt Rehab. 2015;28(4):797-802.

Sundseth J, Kolstad F, Johnsen LG, Pripp AH, Nygaard OP, Andresen H, et al. The neck disability index (NDI) and its correlation with quality of life and mental health measures among patients with single-level cervical disc disease scheduled for surgery. Acta Neurochiru. 2015;157(10):1807-12.

Thompson DP, Urmston M, Oldham JA, Woby SR. The association between cognitive factors, pain and disability in patients with idiopathic chronic neck pain. Disabil Rehab. 2010;32(21):1758-67.

Brenes GA, Penninx BW, Judd PH, Rockwell E, Sewell DD, Wetherell JL. Anxiety, depression and disability across the lifespan. Aging Ment Health. 2008;12(1):158-63.

Luo X, Edwards CL, Richardson W, Hey L. Relationships of clinical, psychologic, and individual factors with the functional status of neck pain patients. Value Health. 2004;7(1):61-9.

Seaman DR, Cleveland C. Spinal pain syndromes: nociceptive, neuropathic, and psychologic mechanisms. J Manipulative Physiol Ther. 1999;22(7):458-72.

Geete DB, Sethiya A, Shetye JV, Kamat MN, Iyer S. Correlation of smartphone usage with functional capacity in young adults. Physiother J Indian Assoc Physiother. 2021;15:93-7.

Nosheen D, Tauqeer S, Arooj A, Anwar N, Ikram A, Farooq N. Pravalence of work related neck pain among nurses. Rawal Med J. 2021;46(1):111-3.

Dave VR, Khanpara HJ, Shukla RP, Sonaliya KN, Tolani J, Patel R. Risk factors of occupation related back pain and neck pain among patients attending tertiary care hospital, Ahmedabad, India. J Prev Med Hyg. 2019;60(4):E419-27.

Chen GL, Wang M, Lu GJ. Investigation of anxiety and depression in chronic pain patients and analysis of related factors. China J Pain Med. 2014;20(4):226-30.




How to Cite

Geete, D. B., Mhatre, B. S., & Iyer, S. (2022). Correlation of disability with anxiety and depression in patients with chronic non-specific neck pain: a cross-sectional observational study. International Journal of Research in Medical Sciences, 10(11), 2478–2483.



Original Research Articles