Association Between Chronic Neck Pain and Increased Risk of Chronic Respiratory Diseases in Middle-Aged and Elderly Chinese Adults: A Cohort Study Based on CHARLS

Q: What was the study objective regarding chronic neck pain and respiratory diseases?

To investigate whether chronic neck pain is associated with an increased risk of developing chronic respiratory diseases in middle-aged and elderly Chinese adults using longitudinal nationally representative data.

Q: How were participants and outcomes defined in this CHARLS cohort study?

The study used 7-year CHARLS data (2011–2018). Participants reported chronic neck pain in the 2011 survey and had no comorbid chronic respiratory diseases at baseline, while chronic respiratory diseases were confirmed based on prior self-reported diagnoses.

Q: What did the study find about the risk of developing chronic respiratory diseases?

After adjusting for confounders, chronic neck pain was significantly associated with incident chronic respiratory diseases (OR = 2.25, 95% CI: 1.77–2.86, P < 0.0001). The association remained significant in both males and females, with a larger effect in males.

Sep 28, 2026

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Chronic neck pain (CNP) and chronic respiratory diseases (CRD) have been reported as potentially related, though prior evidence remains inconsistent. This cohort study evaluates the association between CNP and later CRD in middle-aged and elderly Chinese adults using nationally representative 7-year longitudinal data from CHARLS (2011–2018). Participants with CNP but without baseline chronic respiratory disease were followed and analyzed using logistic regression. Results show CNP increases incident CRD risk after adjustment, with stronger effects in males.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

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Background

Objective

Methods

Results

Conclusion

Introduction

Journal of Pain Research Open Access Full Text Article ORIGINAL RESEARCH Association Between Chronic Neck Pain and Increased Risk of Chronic Respiratory Diseases in Middle-Aged and Elderly Chinese Adults: A Cohort Study Based on CHARLS Mingyang Yi 1 , 2 , Zhen Zhang 1 , 2 , Haixia Li 1–3 , Junting Sai 1 , 2 , Weike Li 1–3 , Zhiwan Wang 1–3 1Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China; 2The First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China; 3Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-Constructed by Henan Province & Ministry of Education of P.R. China, Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China Correspondence: Zhiwan Wang, Email [zhiwan_w@163.com](zhiwan_w@163.com) | Background: Chronic neck pain (CNP) and chronic respiratory diseases (CRD) have been shown to be associated, though such findings remain inconclusive.
Objective: This study aims to investigate the association between CNP and CRD in middle-aged and elderly Chinese populations using nationally representative longitudinal data.
Methods: This study utilized 7-year longitudinal data (2011–2018) from the China Health and Retirement Longitudinal Study (CHARLS) . The study population comprised respondents who reported chronic neck pain (CNP) without comorbid chronic respiratory diseases (CRDs) in the 2011 survey. Pain sites were assessed via self-reported questionnaires, and CRDs were confirmed based on selfreported prior diagnoses. Logistic regression was employed to analyze the association between CNP and CRDs.
Results: A total of 6864 participants were included, with 650 developing CRD during the follow-up. After adjusting for confounding factors such as gender, age, and other chronic diseases, CNP was significantly associated with incident CRD (OR = 2.25, 95% CI: 1.77–2.86, P < 0.0001) . Gender-stratified analyses revealed that the positive association between CNP and CRD risk remained significant in both males (OR = 3.08, 95% CI: 2.11–4.48, P < 0.0001) and females (OR = 1.87, 95% CI: 1.37–2.57, P < 0.0001), with a stronger magnitude observed in males.
Conclusion: Among Chinese CNP patients aged ≥45 years, the risk of developing CRD is increased by 2.25-fold, with evident gender differences. In clinical and community practice, conducting respiratory health assessment and screening for middle-aged and elderly patients with CNP (chronic neck pain), and initiating rehabilitation training as early as possible, is of vital importance for reducing their risk of developing chronic respiratory diseases.
Keywords: chronic neck pain, chronic respiratory diseases, cohort study, CHARLS | | --- | | Introduction
China’s Seventh National Population Census indicates that the country’s elderly population aged 65 and above currently stands at approximately 190 million, with projections indicating an increase to 480 million by 2050, accounting for 37. 8% of the total population.1 With advancing age, physiological functions in the elderly exhibit a declining trend, manifesting as multisystem dysfunction. The number of older adults with chronic conditions continues to rise, often presenting with multiple chronic comorbidities. The Report on the Development of Pain Medicine in China indicates that China currently has over 300 million chronic pain patients, with an annual growth rate of 10–20 million. Middle-aged and elderly individuals constitute a high-risk group for chronic pain.2 With population aging, this trend is projected to persist. The proportion of chronic pain patients among middle-aged and elderly populations will continue to rise and is | Received: 31 August 2025 Accepted: 18 December 2025 Published: 30 December 2025 Journal of Pain Research 2025:18 7275–7286 7275 © 2025 Yi et al. This work

FAQs

What was the study objective regarding chronic neck pain and respiratory diseases?

To investigate whether chronic neck pain is associated with an increased risk of developing chronic respiratory diseases in middle-aged and elderly Chinese adults using longitudinal nationally representative data.

How were participants and outcomes defined in this CHARLS cohort study?

The study used 7-year CHARLS data (2011–2018). Participants reported chronic neck pain in the 2011 survey and had no comorbid chronic respiratory diseases at baseline, while chronic respiratory diseases were confirmed based on prior self-reported diagnoses.

What did the study find about the risk of developing chronic respiratory diseases?

After adjusting for confounders, chronic neck pain was significantly associated with incident chronic respiratory diseases (OR = 2.25, 95% CI: 1.77–2.86, P < 0.0001). The association remained significant in both males and females, with a larger effect in males.

Sep 28, 2026

Uploaded by dhado