From the Guidelines
Yes, straightening and reversal of normal cervical lordosis can cause pain. The cervical spine naturally has a slight forward curve (lordosis) that helps distribute weight properly and absorb shock. When this curve straightens or reverses, it can lead to increased stress on the neck muscles, ligaments, and intervertebral discs, resulting in pain, stiffness, headaches, and sometimes radiating pain into the shoulders and arms. This is supported by the fact that mechanical pain associated with facet joints, intervertebral discs, muscles, or fascia represents the majority of nontraumatic cervical or neck pain, as noted in the ACR Appropriateness Criteria for cervical neck pain or cervical radiculopathy 1.
The altered alignment can develop from various factors including poor posture, muscle imbalances, trauma, degenerative disc disease, or inflammatory conditions. According to the ACR Appropriateness Criteria, it is essential to consider the patient’s medical history to accurately guide imaging and treatment 1. Treatment typically involves a multimodal approach including physical therapy focusing on postural correction and strengthening exercises, over-the-counter pain medications like NSAIDs for short-term pain relief, and sometimes muscle relaxants for muscle spasms.
Some key points to consider in managing pain associated with straightening and reversal of normal cervical lordosis include:
- The importance of maintaining a healthy posture to reduce stress on the neck muscles and intervertebral discs
- The use of ergonomic modifications to workstations and sleeping positions for long-term management
- The potential benefits of heat or ice therapy for temporary relief
- The need for a comprehensive treatment plan that addresses the underlying causes of the altered cervical alignment, as outlined in the ACR Appropriateness Criteria 1.
Overall, the relationship between straightening and reversal of normal cervical lordosis and pain is complex and multifactorial, and treatment should be tailored to the individual patient’s needs and medical history, with a focus on reducing morbidity, mortality, and improving quality of life.
From the Research
Cervical Lordosis and Pain
- The relationship between cervical lordosis and pain has been studied in various research papers 2, 3, 4, 5, 6.
- A study published in 2018 found that reversing a cervical kyphosis into a lordosis can alleviate neck pain and headaches 2.
- Another study published in 2021 found that increasing cervical lordosis through extension traction methods can reduce pain and disability in patients with cervical spine disorders 3.
- A case report published in 2022 found that improving cervical lordosis can relieve neck pain and chronic headaches in a pediatric patient 4.
- A nonrandomized clinical control trial published in 2003 found that chiropractic biophysics seated combined extension-compression and transverse load cervical traction with cervical manipulation can increase cervical lordosis and reduce pain 5.
- A case report published in 2018 found that increasing cervical and lumbar lordosis is possible despite overt osteoarthritis and spinal stenosis, and can relieve low back and leg pain 6.
Straightening and Reversal of Normal Cervical Lordosis
- The studies suggest that straightening or reversal of normal cervical lordosis can cause pain and discomfort 2, 3, 4, 5, 6.
- Reversing a cervical kyphosis into a lordosis can alleviate neck pain and headaches, implying that abnormal curvature can cause pain 2.
- Increasing cervical lordosis through extension traction methods can reduce pain and disability in patients with cervical spine disorders, suggesting that abnormal curvature can contribute to pain 3.
- Improving cervical lordosis can relieve neck pain and chronic headaches in a pediatric patient, further supporting the idea that abnormal curvature can cause pain 4.
Treatment and Rehabilitation
- The studies suggest that treatment and rehabilitation methods such as chiropractic biophysics, extension traction, and spinal manipulation can be effective in increasing cervical lordosis and reducing pain 2, 3, 4, 5, 6.
- A combination of these methods can be used to restore normal cervical lordosis and alleviate pain and discomfort 2, 3, 4, 5, 6.