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Cited by 246Musculoskeletal pain and rehabilitationErgonomics and Musculoskeletal DisordersMyofascial pain diagnosis and treatment

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

Silva, Anabela G., Punt, T. David, Sharples, Paul, Vilas-Boas, João P., Johnson, Mark I.·2009·Archives of Physical Medicine and Rehabilitation
DOI 10.1016/j.apmr.2008.10.018
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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.

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  • In adults aged more than 50 years, CVA was not significantly different between asymptomatic and neck pain subjects (based on one study, n=38).

    “Only one of the eligible studies (n = 38) performed a subgroup analysis using age as a factor and reported that CVA was not significantly different between asymptomatic and neck pain adults aged more than 50 years old”

    From The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis (2019) · cites this paper as [27]

  • Three of four studies investigated upper cervical extension.

    “Concerning upper cervical posture, three of four studies investigated the upper cervical extension [27,33,38], but the difference was significant only in one of them which included only adults [33].”

    From The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis (2019) · cites this paper as [27]

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Authors
Silva, A. G., Punt, T. D., Sharples, P., Vilas-Boas, J. P., & Johnson, M. I.
Affiliations
  • University of Aveiro (PT)
  • Leeds Beckett University (GB)
Corresponding author
Silva, Anabela G.
ORCID
Venue
Archives of Physical Medicine and Rehabilitation
Publisher
Elsevier BV
Published
2009-04
Volume
90
Issue
4
Pages
669-674
ISSN
0003-9993 (ISSN-L)
DOI
10.1016/j.apmr.2008.10.018
OpenAlex
W2036780570
Cited by
246
References
45
Citations by year
2026: 8 · 2025: 11 · 2024: 18 · 2023: 18 · 2022: 24 · 2021: 19 · 2020: 11 · 2019: 20 · 2018: 19 · 2017: 15 · 2016: 20 · 2015: 15 · 2014: 13 · 2013: 11 · 2012: 13
FWCI
5.74
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Archives of Physical Medicine and Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Social Sciences › Psychology › Social Psychology › Ergonomics and Musculoskeletal Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
Keywords
head posture, forward head posture, age differences, standing posture, neck pain
MeSH terms
Adult, Aged, Chronic Disease, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Neck, Posture, Single-Blind Method, Neck Pain

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