Risk factors for neck pain in college students: a systematic review and meta-analysis

Abstract

Abstract Background: During the COVID-19 epidemic, the prevalence of neck pain among college students has increased due to the shift from offline to online learning and increasing academic and employment pressures. Therefore, this systematic review aimed to identify the personal, occupational, and psychological factors associated with the development of neck pain to promote the development of preventive strategies and early intervention treatment. Methods: Seven electronic databases were searched from inception to April 2022 for cross-sectional studies, cohort studies, case-control studies, and randomized controlled trials (RCT) on neck pain. The quality of the selected studies was assessed by American Agency for Healthcare Research and Quality (AHRQ) or the Newcastle-Ottawa scale (NOS). Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated to evaluate the effects of the included risk factors on neck pain. Results: Twenty-six studies were included, including 16,826 participants, and a total of 30 potentially associated risk factors were identified, with 20 factors only listed as risk factors in one or two studies. Ultimately, 10 risk factors were included in the meta-analysis, and all results were statistically significant (P<0.05). The factors supported by strong evidence mainly include the improper use of the pillow (OR=2.20, 95% CI: 1.39 to 3.48), lack of exercise (OR=1.88, 95% CI: 1.53 to 2.30), improper sitting posture (OR=1.97, 95% CI: 1.39 to 2.78), and history of neck and shoulder trauma (OR=2.32, 95% CI: 1.79 to 3.01), senior grade (OR=2.86, 95% CI: 2.07 to 3.95), staying up late (OR=1.80, 95% CI: 1.35 to 2.41), and long-time electronic product usage daily (OR=1.45, 95% CI: 1.27 to 1.65), long-time to bow head (OR=2.04, 95% CI: 1.58 to 2.64), emotional problems (OR=2.09; 95% CI: 1.66, 2.63). Risk factors supported by moderate evidence were high pressure (OR=1.91, 95% CI: 1.50 2.42). Conclusion: Improper use of the pillow, lack of exercise, improper sitting posture, history of neck and shoulder trauma, senior grade, staying up late, long-term electronic product usage daily, long time to bow head, high pressure, and emotional problems affect neck pain in college students. More studies have been conducted to prove the risk and relevance of the remaining 20 factors.