The amount of curve in the neck, or its lordotic curve, can play a key role in neck pain when there is a loss of cervical curve
Aside from back pain, neck pain is one of the most common complaints you will see among chiropractic patients. Neck pain will affect approximately 25% of people at some point in their lives, many times attributed to a loss of cervical curve.
This percentage breaks down to a 12-month prevalence rate that ranges anywhere from 30-50%.1 The amount of curve in the neck, or its lordotic curve, can play a key role in neck pain. This cervical curve acts as a shock absorber, helps support the head, and keeps the neck and head in proper alignment over the spine.
If the neck loses this curve – known as lordosis – it can lead to pain and pressure, making it difficult to move. What are the common causes and symptoms of lordosis, and how can it be treated?
Symptoms and causes of loss of cervical curve
If the neck is curving in an abnormal fashion, the muscles will often pull in different directions, causing them to tighten or spasm. The resulting pain can often extend to the shoulders and upper back, which may exacerbate the condition.
Patients with loss of cervical curve or cervical lordosis may also have decreased neck and shoulder mobility.2 Common causes for cervical lordosis can include poor posture, injury (such as whiplash), disc herniation, or degenerative disc disease.
What does the research say?
There have been several published single case studies that show the benefits of specific types of spinal manipulation for treating cervical lordosis.2-4 One of the drawbacks to single case studies, however, is that they only follow the course of one patient. While it is true that these individual cases do show that spinal manipulation provides positive results for those individual patients, it is difficult to draw much more in the way of conclusions beyond that, unless the individual case studies are pooled together for a meta-analysis.
However, a 2015 study published in Chiropractic & Manual Therapies compared the angle of the lordotic curve for a group of 29 patients with chronic neck pain against a group of 30 controls to determine if manipulation improved cervical lordosis.4 The patients with neck pain underwent two manipulation sessions per week for a total of four weeks. Measurements were taken for both groups at baseline and at the end of the treatment sessions for those with neck pain.
At the end of the study, the patients with neck pain did show improvement in their loss of cervical curve, however, it was unclear if the positive change was enough to be attributed to the cervical manipulation.4
Evidence in treating loss of cervical curve
Despite the lack of conclusive evidence linking the increase in cervical curvature to the treatment, the researchers noted that their study still is a step in the right direction, as it did show that there was benefit compared to a control group. Furthermore, a larger study might have enough power to achieve the strength needed to prove that the positive change in the lordotic curve was attributable to cervical manipulation.4
Given the number of conditions that are associated with cervical lordosis, as well as the large body of evidence supporting the benefits of chiropractic for treating neck pain in general, it does not seem too much of a stretch to say that chiropractic successfully treats a loss of cervical curve as well. Furthermore, the current research trend appears to be headed in that direction.
References
- Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: A systematic critical review of the literature. European Spine Journal. 2006 Jun;15(6):834-848.
- Dennis AK, Oakley PA, Weiner MT, et al. Alleviation of neck pain by the non-surgical rehabilitation of a pathologic cervical kyphosis to a normal lordosis: A CBP® case report. Journal of Physical Therapy Science. 2018;30(4):654-657.
- Fortner MO, Oakley PA, Harrison DE. Alleviation of posttraumatic dizziness by restoration of the cervical lordosis: A CBP® case study with a one year follow-up. Journal of Physical Therapy Science. 2018;30(5):730-733.
- Wickstrom BM, Oakley PA, Harrison DE. Non-surgical relief of cervical radiculopathy through reduction of forward head posture and restoration of cervical lordosis: A case report. Journal of Physical Therapy Science. 2017;29(8):1472-1474.
- Shilton M, Branney J, de Vries BP, Breen AC. Does cervical lordosis change after spinal manipulation for non-specific neck pain? A prospective cohort study. Chiropractic & Manual Therapies. 2015;23:33.
