Relationship of forward head posture with cervical muscle thickness and neck pain-related disability among young adults: a cross-sectional study

Abstract

Background

Forward head posture (FHP) is a common postural disorder in patients with neck pain. Despite the intuitive assumption that FHP determines neck pain characteristics, its effect on neck pain and cervical muscle morphology is unclear.

Objectives

To evaluate whether FHP affects cervical muscle morphology and neck pain-related disability among young adults.

Methods

Young adults with chronic neck pain older than 18 years were divided into 2 groups according to craniovertebral angle (CVA): those with FHP (≤49°) and those without. Neck pain severity and disability were evaluated with a numeric rating scale (NRS) and the neck disability index (NDI). Semispinalis capitis and sternocleidomastoid muscle thicknesses were measured via ultrasonography.

Results

Twenty-one females and 31 males were evaluated. The mean ages of those with and without FHP were 19.9 ± 1.1 and 20.0 ± 1.1 years, respectively. The incidence of FHP was significantly greater in females (73 %) (p < 0.001). The normalized muscle thickness for body weight of both the semispinalis capitis and sternocleidomastoid muscle, the NRS pain score, and the NDI were similar between the groups. CVA was weakly negatively correlated with pain but was not correlated with cervical muscle thickness or disability. There was a weak negative correlation between semispinalis capitis muscle thickness and the NRS pain scores.

Conclusions

The frequency of FHP is greater in females. The presence of FHP was unrelated to neck pain severity or cervical muscle thickness and disability in individuals with chronic neck pain. There was a mild negative correlation between extensor muscle thickness and neck pain regardless of FHP.