Ann Rehabil Med.  2014 Dec;38(6):821-826. 10.5535/arm.2014.38.6.821.

Radiologic Assessment of Forward Head Posture and Its Relation to Myofascial Pain Syndrome

• Sun A
• Yeo HG
• Kim TU
• Hyun JK
• Kim JY

• KMID: 2267093
• DOI: http://doi.org/10.5535/arm.2014.38.6.821

Abstract

OBJECTIVE
To assess head posture using cervical spine X-rays to find out whether forward head posture is related to myofascial pain syndrome (MPS) in neck and shoulder.
METHODS
Eighty-eight participants who were diagnosed with MPS in neck and shoulder were evaluated in this study. Four parameters (distance among head, cervical spines, and shoulder, and cervical angle) were measured from lateral view of cervical spine X-ray. The location and number of trigger points in the neck and shoulder and symptom duration were evaluated for each patient.
RESULTS
Both horizontal distances between C1 vertebral body and C7 spinous process and between the earhole and C7 vertebral body were negatively correlated with cervical angle reflecting cervical lordosis (p<0.05). Younger patients had significantly (p<0.05) less cervical angle with more forward head posture. There was no relationship between MPS (presence, location, and number of trigger points) and radiologic assessments (distance parameters and the cervical angle).
CONCLUSION
Forward head posture and reduced cervical lordosis were seen more in younger patients with spontaneous neck pain. However, these abnormalities did not correlate with the location or the number of MPS. Further studies are needed to delineate the mechanism of neck pain in patients with forward head posture.

Keyword

Cervical vertebrae; Lordosis; Neck pain; Myofascial pain syndromes; Trigger points

MeSH Terms

Animals
Cervical Vertebrae
Female
Head*
Humans
Lordosis
Myofascial Pain Syndromes*
Neck
Neck Pain
Posture*
Shoulder
Spine
Trigger Points

Figure

• 

  Fig. 1 The horizontal distance 1, 2, 3, and 4 were measured by using the lateral view of cervical spine X-ray. Distant 1 was the horizontal distance between the earhole and lateral shoulder. Distant 2 was the horizontal distance between plump line of posterior neck and posterior shoulder. Distant 3 was the horizontal distance between the anterior margin of C1 body and the posterior margin of C7 spinous process. Distant 4 was the horizontal distance between the earhole and midline of C7 lower margin.

• 

  Fig. 2 The cervical angle was measured by using lateral view of cervical spine X-ray. The angle from the C2 through C7 vertebrae using the posterior tangent method for analysis of cervical lordosis was depicted. The angle between the two tangent lines (C2-C7) at the posterior vertebral margins represented the curvature of the cervical spine [16].

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