Association Between Exam-Related Anxiety and Neck Pain Among University Students

Abstract

Background: Neck pain is a common musculoskeletal complaint among university students and is increasingly understood within a biopsychosocial framework. Examination periods represent high-stress academic intervals during which psychological strain may contribute to cervical muscle tension and functional impairment. However, limited evidence has specifically examined the association between exam-related anxiety and neck disability using condition-specific instruments. Objective: To determine the association between exam-related anxiety and neck disability among university students during the examination period. Methods: A cross-sectional observational study was conducted among 110 university students aged 18–30 years. Exam-related anxiety was measured using the Westside Test Anxiety Scale (WTAS), and neck disability was assessed using the Neck Disability Index (NDI). Normality was evaluated using the Shapiro–Wilk test. Due to non-normal distribution of WTAS scores (p = 0.032), Spearman’s rank-order correlation was used to assess association between variables. Results: The mean age of participants was 22.97 ± 2.43 years. The mean WTAS score was 4.12 ± 0.49, and the mean neck disability score was 62.63 ± 10.69. A statistically significant weak positive correlation was observed between exam-related anxiety and neck disability (ρ = 0.251, p = 0.008), with an approximate shared variance of 6.3%. Conclusion: Higher levels of exam-related anxiety were associated with modest increases in neck disability among university students. These findings support the integration of psychological and ergonomic interventions during examination periods to enhance student well-being.