Clinical indicators associated with pain trajectories in non-specific neck pain: a secondary analysis of a…

ObservationalBMJ open· Aug 2026

Clinical indicators associated with pain trajectories in non-specific neck pain: a secondary analysis of a multicentre prospective observational cohort to develop a clinical compass for personalised physiotherapy in primary care.

Martine J Verwoerd, Richard A W Felius, Sophie Konings … Rob J E M Smeets

Musculoskeletal RehabilitationObservationalPrognosisQ1IF 2.5

24 clinical indicators are linked to how neck pain recovers over 6 months

Clinical indicators associated with pain trajectories in non-specific neck pain: a secondary analysis of a multicentre prospective observational cohort to develop a clinical compass for personalised physiotherapy in primary care.

Martine J Verwoerd … Rob J E M Smeets

BMJ open · Aug 2026 · Q1 in General Medicine

Purpose

To identify clinical indicators reflecting potentially treatment-modifiable prognostic factors associated with pain recovery in patients with non-specific neck pain and to develop a prototype clinical compass for visualising patient-specific profiles.

Methods

30 physiotherapy primary care practices.

n = 603 participants

Results

24

more of these factors present, worse pain recovery over time

n = 603 participants

More results

A quadratic growth-curve model best explained the longitudinal change of pain intensity.

Two characteristics were excluded as they demonstrated high intercorrelation.

Based on these findings, a clinical compass comprising 22 clinical indicators was developed to visualise patient-specific profiles.

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Conclusion

This study provides a prototype clinical compass that may inform prognostic reasoning in primary care physiotherapy, but further evaluation is needed before clinical implementation.

Clinical indicators associated with pain trajectories in non-specific neck pain: a secondary analysis of a multicentre prospective observational cohort to develop a clinical compass for personalised physiotherapy in primary care.

Clinical indicators associated with pain trajectories in non-specific neck pain: a secondary analysis of a multicentre prospective observational cohort to develop a clinical compass for personalised physiotherapy in primary care.

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