Prospective, population-based study of occupational movements and postures of the neck as risk factors for cervical disc herniation

Abstract

ObjectiveWe studied the associations between objectively measured occupational neck exposures in a job exposure matrix (JEM) and cervical disc herniation (CDH).DesignA cohort study of Danish workers who ever held at least one of 29 jobs (eg, dentists, hairdressers, childcare, carpenters) from 1981 to 2016 was formed. Representative whole work-day inclinometric measurements from previous studies using triaxial accelerometers measuring neck angular velocity and posture of the neck were used as exposure in a JEM. Job titles were retrieved from the Danish Occupational Cohort with eXposure data database. The risk of CDH by quintiles of cumulated exposure was assessed by incidence rate ratios (IRR), adjusted for age, sex, calendar-year, previous lumbar disc herniation and educational level, using Poisson regression models.SettingNationwide Danish registers.Participants852 625 Danish workers within 29 different job-titles.Outcome measuresFirst diagnosis of CDH was retrieved from the Danish National Patient Register.ResultsWe found 14 000 cases of CDH during 20.2 million person-years of follow-up. Increasing levels of neck angular velocity showed a decreasing risk with IRR 0.90 (95% CI 0.86 to 0.95) when the highest level of cumulative exposure (dynamic work) was compared with the lowest (static work). Similar results were found for extension and flexion of the neck, though not statistically significant for extension. Multiple sensitivity analyses did not change the results.ConclusionIn this large register-based study based on a JEM, we found no evidence of an increased risk of CDH with increasing cumulated angular velocity, flexion or extension of the neck. Factors other than occupational dynamic neck movements and bent neck position seem to be important in the development of CDH.

Myofascial release for the treatment of pain and dysfunction in patients with chronic mechanical neck pain: Systematic review and meta-analysis of randomised controlled trials

“…39 In this study, we explored the effects of MFR on pain and dysfunction in individuals with MNP. A recent study has demonstrated that MNP has less effect on cervical posture, 40 but more effect on muscle function, especially on the trapezius muscle. 38 Collectively, our study demonstrated that MFR is an effective treatment for the improvement of cervical function in patients with MNP.…”

Association between Occupation and Cervical Disc Degeneration in 1211 Asymptomatic Subjects

“…The authors hypothesized that the increased risk may relate to vibration and road shocks, twisting of the neck during acceleration and deceleration, and whiplash accidents, compared to heavy lifting, especially considering the current mechanization of loading and unloading [ 23 ]. Petersen et al found no evidence of a positive association or an exposure-response effect of neck movements or neck positions on the risk of cervical disc herniation when using a job exposure matrix based on representative inclinometric measurements of the neck and register-based outcome measures [ 24 ].…”