Isometric Exercise for the Cervical Extensors Can Help Restore Physiological Lordosis and Reduce Neck Pain: A Randomized Controlled Trial

Am J Phys Med Rehabil. 2017 Sep;96(9):621-626. doi: 10.1097/PHM.0000000000000698.


Objective: The aim of this study was to investigate whether isometric neck extension exercise restores physiological cervical lordosis and reduces pain.

Design: Sixty-five patients with loss of cervical lordosis were randomly assigned to exercise (27 women, 7 men; mean age, 32.82 ± 8.83 yrs) and control (26 women, 5 men; mean age, 33.48 ± 9.67 yrs) groups. Both groups received nonsteroidal anti-inflammatory drugs for 10 days. The exercise group received additional therapy as a home exercise program, which consisted of isometric neck extension for 3 mos. Neck pain severity and cervical lordosis were measured at baseline and at 3 mos after baseline.

Results: Compared with baseline levels, cervical lordosis angle was significantly improved in the exercise group (P < 0.001) but not in the control group (P = 0.371) at the end of 3 mos. Moreover, the exercise group was significantly superior to the control group considering the number of patients in whom cervical lordosis angle returned to physiological conditions (85.2% vs. 22.5%; P < 0.001). At the end of 3 mos, pain intensity was significantly reduced in both groups compared with baseline levels (for all, P < 0.001). Nevertheless, considering the change from baseline to month 3, the reduction in pain was about twice in the exercise group compared with the control group (P < 0.001).

Conclusions: Isometric neck extension exercise improves cervical lordosis and pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cervical Vertebrae / physiopathology
  • Exercise Therapy / methods*
  • Exercise*
  • Female
  • Humans
  • Lordosis / complications
  • Lordosis / physiopathology
  • Lordosis / rehabilitation*
  • Male
  • Neck Muscles / physiopathology
  • Neck Pain / etiology
  • Neck Pain / physiopathology
  • Neck Pain / rehabilitation*
  • Pain Measurement
  • Prospective Studies
  • Single-Blind Method
  • Treatment Outcome