Misalignment & Neck Pain: Get the Facts on Forward Head Posture

Individuals that sit at a desk/workstation for hours for work or school, or drive for a living, could be fostering a long-term condition known as forward head posture. Can understanding the signs and symptoms help to prevent the condition?

Forward Head Posture

Neck pain often causes or is caused by misalignment in the area between the shoulders and head. Forward head posture is a common problem that can strain the neck muscles, leading to pain and worsening neck, shoulder, and back posture. (Jung-Ho Kang, et al., 2012) For individuals who are at risk of developing or are already showing signs/symptoms, it’s important to get medical attention to prevent complications, such as chronic neck pain or compressing a nerve. Individuals can continue to do the work that they need to do but may need some postural adjustments and re-training so as not to continue straining the neck while working.

Postural Deviation

• The head is in a healthy alignment with the neck when the ears line up with the gravity line.
• The gravity line is an imaginary straight line that represents gravity’s downward pull.
• It is used in posture assessments as a reference for noting the positions of the body and determining the presence of any postural misalignment or deviation.
• A forward head posture occurs when the head begins to position forward of the gravity line when looking at the body from the side.
• Forward head posture is a postural deviation because the head varies from the reference line. (Jung-Ho Kang, et al., 2012)

Muscle Imbalances

• Forward head posture often results in a strength imbalance between muscles that support and move your neck, shoulders, and head. (Dae-Hyun Kim, et al., 2018)
• The muscles in the back of the neck become shortened and overactive as they flex forward, while the muscles in the front become lengthened, weaker, and strained when they relax.

Kyphosis

Kyphosis also known as hunchback is when the shoulders round forward, and the head is also brought forward. (Jung-Ho Kang, et al., 2012) After many hours sitting at a desk, computer, or driving, kyphosis can also cause and/or worsen forward head posture.

• This occurs because the upper back area supports the neck and head.
• When the upper back moves or changes position, the head and neck follow.
• The majority of the head’s weight is in the front, and this contributes to the forward movement.
• An individual with kyphosis has to lift their head to see.

Treatment

A chiropractic injury specialist team can develop a personalized treatment plan to relieve pain symptoms, provide postural retraining, realign the spine, and restore mobility and function.

• Standing and sitting using a healthy posture, along with exercises to strengthen the neck muscles, can help get the spine in alignment. (Elżbieta Szczygieł, et al., 2019)
• Targeted stretching can help if the neck muscles are tight.
• At-home stretches may also relieve pain.

Risk Factors

Pretty much everyone is at risk of developing a forward head posture. Common risk factors include:

• Constantly looking down at a phone and staying in this position for a long time aka text neck.
• Desk jobs and computer use can significantly round the shoulders and upper back, leading to a forward head posture. (Jung-Ho Kang, et al., 2012)
• Driving for a living causes prolonged back, neck, and shoulder positioning.
• Sleeping or reading with a large pillow under the head can contribute to forward head posture.
• Doing work that requires dexterity and close-up positions, like a seamstress or technician can cause over-positioning of the neck.
• Individuals who regularly carry a significant amount of weight in front of their body may begin to develop kyphosis.
• An example is carrying a child or another load in front of the body.
• Large breasts can also increase the risk of kyphosis and forward head posture.

Neck Injuries

References

Kang, J. H., Park, R. Y., Lee, S. J., Kim, J. Y., Yoon, S. R., & Jung, K. I. (2012). The effect of the forward head posture on postural balance in long time computer based worker. Annals of rehabilitation medicine, 36(1), 98–104. doi.org/10.5535/arm.2012.36.1.98

Kim, D. H., Kim, C. J., & Son, S. M. (2018). Neck Pain in Adults with Forward Head Posture: Effects of Craniovertebral Angle and Cervical Range of Motion. Osong public health and research perspectives, 9(6), 309–313. doi.org/10.24171/j.phrp.2018.9.6.04

Szczygieł, E., Sieradzki, B., Masłoń, A., Golec, J., Czechowska, D., Węglarz, K., Szczygieł, R., & Golec, E. (2019). Assessing the impact of certain exercises on the spatial head posture. International journal of occupational medicine and environmental health, 32(1), 43–51. doi.org/10.13075/ijomeh.1896.01293

Hansraj K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277–279.