Head Posture and Neck Pain of Chronic Nontraumatic Origin: A Comparison Between Patients and Pain-Free Persons

Arch Phys Med Rehabil. 2009 Apr;90(4):669-74. doi: 10.1016/j.apmr.2008.10.018.

Abstract

Objective: To compare standing head posture measurements between patients with nontraumatic neck pain (NP) and pain-free individuals.

Design: Single-blind (assessor) cross-sectional study.

Setting: Hospital and general community.

Participants: Consecutive patients (n=40) with chronic nontraumatic NP and age- and sex-matched pain-free participants (n=40).

Interventions: Not applicable.

Main outcome measures: Three angular measurements: the angle between C7, the tragus of the ear, and the horizontal; the angle between the tragus of the ear, the eye, and the horizontal; and the angle between the inferior margins of the right and the left ear and the horizontal were calculated through the digitization of video images.

Results: NP patients were found to have a significantly smaller angle between C7, the tragus, and the horizontal, resulting in a more forward head posture than pain-free participants (NP, mean +/- SD, 45.4 degrees +/-6.8 degrees ; pain-free, mean +/- SD, 48.6 degrees +/-7.1 degrees ; P<.05; confidence interval [CI] for the difference between groups, 0.9 degrees -6.3 degrees ). Dividing the population according to age into younger (</=50y) and older (>50y) revealed an interaction, with a statistically significant difference in head posture for younger participants with NP compared with younger pain-free participants (NP, mean +/- SD, 46.1 degrees +/-6.7 degrees ; pain-free, mean +/- SD, 51.8 degrees +/-5.9 degrees ; P<.01; CI for the difference between groups, 1.8 degrees -9.7 degrees ) but no difference for the older group (NP, mean +/- SD, 44.8 degrees +/-7.1 degrees ; pain-free, mean +/- SD, 45.1 degrees +/-6.7 degrees ; P>.05; CI for the difference between groups, -4.9 degrees -4.2 degrees ). No other differences were found between patients and pain-free participants.

Conclusions: Younger patients with chronic nontraumatic NP were shown to have a more forward head posture in standing than matched pain-free participants. However, the difference, although statistically significant, was perhaps too small to be clinically meaningful.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck / anatomy & histology
  • Neck Pain / physiopathology*
  • Posture / physiology*
  • Single-Blind Method