Physical risk factors for neck pain

To identify physical risk factors for neck pain, a systematic review of the literature was carried out. Based on methodological quality and study desi gn, 4 levels of evidence were defined to establish the strength of evidence for the relationship between risk factors and neck pain. Altogether, 22 cr oss-sectional studies, 2 prospective cohort studies, and 1 case-referent st udy were eligible for determining the level of evidence. The results showed some evidence for a positive relationship between neck pain and the durati on of sitting and twisting or bending of the trunk. A sensitivity analysis was carried out excluding 3 items of the quality list, the importance of wh ich seemed doubtful. On the basis of this sensitivity analysis, it was conc luded that there is some evidence for a positive relationship between neck pain and the following work-related risk factors: neck flexion, arm force, arm posture, duration of sitting, twisting or bending of the trunk, hand-ar m vibration, and workplace design.