Neck pain is a common health condition that generates high levels of disability, consumption of healthcare services, and lost productivity. Cost-of-illness studies can provide insights into the economic impact of a specific illness, which informs policy makers and justifies intervention programs. However, there is a lack of literature summarizing the economic burden of neck pain.

To conduct a systematic review to summarize the healthcare costs related to neck pain.

The search was conducted in seven databases (PubMed, EMBASE, CINAHL, SPORTDISCUS, EconLit, National Health Service Economic Evaluation Database, and Health Technology Assessment Database) on 18 December 2024. Cross-sectional and cohort studies that measured the healthcare costs related to neck pain, regardless of the duration of symptoms, in adults over 18 years old of both sexes were included. Healthcare costs included prescribed medication and healthcare services consumed by patients. All costs were inflated for the same reference year (2023) using the Consumer Price Index of each country and converted to International Dollar ($). The results were presented descriptively.

Four studies were included for data extraction. None of the studies reported onset or duration of neck pain symptoms. Two studies provided relevant information on the description of the components of healthcare costs of neck pain, being the costs of hospitalization and procedures the most cited. In The Netherlands (high-income country), the total healthcare costs were $291,901,827 in a 12-month period. Separately, hospital care costs were $31,702,814 (10,9%), medical procedures were $3,969,432 (1,3%), medical specialist fees were $2,901,739 (1%), ambulatory hospital care were $1,328,099 (0,5%), general practice were $7,973,887 (2,7%), and paramedical care costs were $244,025,856 (83,6%). In Brazil (upper-middle-high income country), the total healthcare costs were $6,090,870 in a 12-month period. Separately, hospital costs were $3,730,247 (61,2%), professional costs were $625,037 (10,3%), intensive care unit costs were $397,926 (6,5%), companion stay costs were $17,550 (0,3%), and outpatient costs were $1,320,110 (21,7%). Two studies were conducted in the United States (high-income country). One study found that early physiotherapy initiation resulted in lower one-year costs per patient ($2,438) compared to late initiation ($5,299, p < 0.001), while the other study showed that total healthcare costs were $439,681,567 in a 12-month period per patient.

The total healthcare costs of neck pain ranged from $6,090,870 to $439,681,567. Since three studies included in this systematic review were from high-income countries, further studies are needed to better estimate the healthcare costs of neck pain worldwide. Additionally, prospective cohort studies are needed to provide a more accurate assessment of the healthcare costs of neck pain and to inform and support clinical decision-making, considering a standardization of the cost estimation and reporting methods, as well as a clear definition of neck pain.

This review highlights a large variation in the healthcare costs of neck pain, which emphasizes the need to standardize cost estimation and reporting for better comparability and decision-making. Despite this, early physiotherapy initiation, compared to late, reduces costs. Policymakers can use these data to promote early physiotherapy referral and prioritize conservative treatments.