Comparison of Neck-Related Disability Among Adults Residing in Rural And Urban Communities: A Cross-Sectional Study

Abstract

Background: Neck pain is a common musculoskeletal problem that can interfere with daily activities, work, and overall well-being. The effect of neck pain may differ depending on a person's lifestyle, occupation, working conditions, and living environment. Rural adults may be exposed to physically demanding work and repetitive activities, while urban adults may experience prolonged sitting and screen-based activities. However, comparatively less attention has been given to understanding how neck-related disability differs between rural and urban communities.

Aim: To determine and compare neck pain and neck-related disability among adults residing in rural and urban communities.

Methodology: A comparative cross-sectional study was conducted in a community setting over a period of six months. A total of 200 adults with mechanical or non-specific neck pain were included, comprising 100 participants from rural communities and 100 from urban communities. Participants aged 20–45 years who fulfilled the inclusion criteria were selected through random sampling. Neck-related disability was assessed using the Neck Disability Index (NDI), pain intensity was measured using the Numerical Pain Rating Scale (NPRS), and the overall physical and psychosocial impact of neck pain was assessed using the Neck Bournemouth Questionnaire (NBQ). Appropriate statistical tests were applied to compare the outcomes between rural and urban groups, with statistical significance considered at p<0.05.

Results: The findings demonstrated a clear difference in the severity of neck-related disability between the two communities. Rural participants had a higher median NDI score of 54% compared with 40% in urban participants, and this difference was statistically significant (U=2402, Z=-6.355, p<0.001). Severe and complete disability together was observed in 65% of rural participants compared with 21% of urban participants. Pain intensity was also higher among rural participants, with a median NPRS score of 6 compared with 5 in the urban group (U=3473, Z=-3.783, p<0.001). Similarly, the mean NBQ percentage score was higher among rural participants (50.69±14.77%) than urban participants (39.25±15.25%), showing a statistically significant difference (t=5.388, p<0.001).

Conclusion: Neck pain and related disability were commonly observed among adults in both rural and urban communities. However, participants from rural communities experienced greater pain intensity, higher levels of functional disability, and a greater overall physical and psychosocial burden related to their neck problems. These findings highlight the importance of early identification, postural and ergonomic education, regular physical activity, and community-based physiotherapy interventions, particularly in rural populations.