The relationship between head posture and severity and disability of patients with neck pain

Man Ther. 2008 May;13(2):148-54. doi: 10.1016/j.math.2006.11.002. Epub 2007 Mar 23.


Study design: A cross-sectional correlation study.

Objectives: To investigate the relationship between head posture with pain and disability in patients with neck pain.

Method: Sixty-two subjects with neck pain and 52 normal subjects were recruited by convenience sampling. The forward head posture was measured via the craniovertebral (CV) angle by using the Head Posture Spinal Curvature Instrument (HPSCI). The Chinese version of Northwick Park Neck Pain Questionnaire (NPQ) and Numeric Pain Rating Scale (NPRS) were used to assess neck pain disability and severity. The difference in CV angles between the two groups and Pearson's correlation coefficient between the CV angle, NPQ and NPRS were determined.

Results: There was a significant difference in the CV angle between subjects with and without neck pain. CV angle was negatively correlated with NPQ (r(p)=-0.3101, p=0.015) and NPRS (r(p)=-0.329,p=0.009). It was also negatively correlated with age (r(p)=-0.380,p=0.002). When age was taken into account, the CV angle was negatively correlated with NPQ (r(p)=-0.3101,p=0.015) but showed no significant correlation with NPRS (r(p)=-0.1848,p=0.154).

Conclusion: The CV angle in subjects with neck pain is significantly smaller than that in normal subjects. There is moderate negative correlation between CV angle and neck disability. Patients with small CV angle have a greater forward head posture, and the greater the forward head posture, the greater the disability.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Disability Evaluation*
  • Female
  • Head*
  • Humans
  • Male
  • Neck Pain / diagnosis*
  • Observer Variation
  • Posture*
  • Reproducibility of Results
  • Severity of Illness Index*