Objectives In the literature the high prevalence of pain in many epidemiological studies is under discussion, and to what degree the prevalence reflects severe pain. The aim of the present study was to evaluate the validity of simple neck pain assessments, often used in large epidemiological survey studies, in relation to aspects of health-related quality-of-life and decreased general performance.

Methods A cohort of university students (baseline age 19–25 years), were recruited in 2002 and followed annually for 4 years. The baseline response rate was 70 percent, representing by 1200 respondents (627 women, 573 men) to the questionnaire. The data were analysed using a mixed model for repeated measurements and a random intercept logistic model.

Results In the study 26% of the women and 11% of men reported present pain, and 33% of women and 14% of men reported a pain period past year. Both present pain and pain period was associated with lower general health, higher stress, sleep disturbance and decreased general performance. Contrary to our hypothesis, the results did not indicate evidence that pain period reflects, in some sense, a more severe pain than do present pain.

Conclusions Simple pain assessments, of present pain and pain period, capture features of pain that affect aspects of health-related quality-of-life and a perceived decrease in general performance. Duration of pain did not increase the quality of the assessment in the hypothesised manner. Further analyses are needed to evaluate validity with regard to other outcomes (as mental well-being) and other populations.