From the Guidelines
For a patient without a normal lordotic curve of the cervical spine, the recommended therapies to correct the curvature include physical therapy exercises, ergonomic modifications, and potentially surgical interventions, but chiropractic therapy is conditionally recommended against due to potential cervical spine complications. When considering treatment options, it's crucial to prioritize therapies that are evidence-based and minimize risk.
- Physical therapy exercises focused on cervical extension, chin tucks, and postural correction can be beneficial, with a regimen of exercises to be performed 2-3 times daily, with 10-15 repetitions per exercise.
- Ergonomic modifications are essential, including proper workstation setup, supportive pillows during sleep, and awareness of "tech neck" posture during device use.
- For pain management, NSAIDs like ibuprofen (400-600mg every 6-8 hours) or naproxen (220-440mg twice daily) may be used short-term.
- In severe cases with persistent neurological symptoms, surgical interventions such as anterior cervical discectomy and fusion (ACDF) or artificial disc replacement might be considered. It's worth noting that chiropractic therapy is conditionally recommended against, as stated in the 2023 guideline by the American College of Rheumatology 1, due to the potential cervical spine complications that can occur, particularly in patients with rheumatoid arthritis. The goal of these treatments is to restore the natural cervical lordosis, which is important for proper biomechanical function, stress distribution, and prevention of accelerated degenerative changes in the cervical spine.
From the Research
Recommended Therapies for Correcting Cervical Lordosis
The following therapies are recommended to correct the curvature of the cervical spine:
- Chiropractic BioPhysics (CBP) methods, including mirror image, neck extension exercises, cervical extension traction, and spinal manipulative therapy 2, 3
- Cervical extension traction methods to increase cervical lordosis in those with hypolordosis and cervical spine disorders 4
- Rehabilitation programs that incorporate cervical extension protocols to restore cervical lordosis and reduce forward head translation 2, 3
Key Findings
- A case report demonstrated the therapeutic reversal of a cervical kyphosis into a lordosis in a patient with neck pain and headaches using CBP methods 2
- A selective review of CBP case reports found an average improvement of 14° in cervical lordosis and a 12 mm reduction in forward head position after 40 treatments over 16 weeks 3
- A systematic review of controlled trials found that cervical extension traction methods increased radiographically measured lordosis by 12-18° over 5-15 weeks, and maintained pain and disability improvements up to 1.5 years later 4