Does Forward Head Posture Cause Neck Pain? – A Systematic Review

head posture and pain

A recent systematic review 1 published in November of 2019 in ‘Current Reviews in Musculoskeletal Medicine’ went over the relationship between neck pain and head posture. The results of the review found that age played a vital role.

What Was the Purpose?

Research has shown that neck pain is a common issue in the human population. It goes on to adversely impact a person’s family, business, healthcare, etc. Apparently, human neck pain’s overall prevalence in the general population can be more than 86%. When considering the physical factors, neck pain showed a strong association with a person’s neck having a forward bent for a long time as well as making repetitive movements.

The risk of neck pain has increased due to more people spending hours in front of screens for work or leisure in unhealthy postures. The forward head posture or FHP is the most common cervical postural fault. A higher FHP level is linked to higher deficits in a person’s cervical range of motion (specifically the neck’s flexion and rotation).

Furthermore, static balance control in asymptomatic adults is reported to be negatively impacted by FHP. However, there are still contradictory results. That’s why this study set out to determine whether or not FHP showed any differences between asymptomatic and neck pain subjects — investigating the relationship between neck pain and head posture was the study’s secondary objective.

The Methodology

This review covered the electronic databases EMBASE, MEDLINE/PubMed, Cochrane Library Web search, Physiotherapy Evidence Database (PEDro), and CINAHL for observational studies that were published in English and indexed from 2009 to April 2017. Also, an updated search was performed on 19 September 2018. Mendeley Desktop was used for importing abstracts and titles. The duplicates and irrelevant articles were removed.

An adapted form of the EPHPP (Effective Public Health Practice Project) assessment tool was utilized for determining the quality of selected articles.

What Did the Results Show?

A total of 15 cross-sectional studies were deemed eligible to be included in this meta-analysis and systematic review procedure. A total of 10 studies compared FHP between the group of participants with neck pain and a group of asymptomatic participants. Eight studies displayed a significant negative correlation between the intensity of neck pain and FHP (as well as disability in older adults and adults).

Furthermore, when it came to adolescents, the significant predictors of FHP were doctor visits and lifetime prevalence.

What was Concluded?

The current review shared that age seemed to play a vital role as a confounding factor when it came to the relation between neck pain and FHP. Also, the results of this review helped conclude that increased Forward Head Posture was seen in adults with neck pain when compared to adults that were asymptomatic.

Other than that, FHP was determined to be highly correlated with neck pain measures linked to adults as well as older adults. Take note; no association could be found between most neck pain measures in adolescents and FHP.

More in-depth research is required to help people realize the damaging effects of their posture and how it relates to them experiencing neck pain.

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