First-episode vs recurrent nonspecific neck pain: clinical characteristics, recovery, and the impact of pain severity on well-being and functionality.

Objective: This study (1) compared clinical characteristics between patients with first-episode and recurrent nonspecific neck pain (NSNP), and (2) examined differences in daily activities and psychological well-being between patients with minimal pain (1-2 numeric pain rating scale) and moderate to severe pain (≥3 numeric pain rating scale) at 6 weeks postpresentation. Methods: The study was conducted across 30 primary physiotherapy practices and included patients experiencing a new NSNP episode lasting ≤12 weeks. For the first research objective, baseline data collection encompasses neck pain symptoms, prior conditions, and work-related, general, psychological, and behavioral factors. In addition, pain intensity was measured at 6-week, 3-month, and 6-month follow-ups. For the second objective, pain intensity, psychological factors, and disability were assessed. Results: No clinically meaningful differences were observed in clinical characteristics or recovery rates between patients with first-episode and recurrent NSNP. However, meaningful differences were found in disability, patient concerns, and self-efficacy between minimal and moderate to severe pain groups at 6 weeks. Patients with higher pain intensity had higher disability scores (1.33-point [SD 0.84-1.81]) difference on a 0 to 7 scale, lower self-efficacy (-1.25-point [SD -1.84 to -0.65]) difference on a 0 to 12 scale, and greater concerns (1.87-point [SD 1.21-2.52] difference on a 0 to 10 scale). Conclusion: No clinically meaningful differences in clinical characteristics or pain recovery rates exist between first-episode and recurrent NSNP. However, significant and clinically meaningful differences exist in the impact of pain severity on daily activities, patient concerns, and self-efficacy.