Flat Neck Syndrome Causes and Treatment

A normal neck has a gentle curve to it. However, it's possible to lose that curve because of an injury or because your neck has been aligned badly for a long time. If your neck loses its curve, it can affect the posture of your whole body.

Losing your neck's natural curve can have several different names depending on what's causing it. You might hear it described as:

• Flat neck syndrome
• Cervical kyphosis
• Military neck
• Reversed neck curve (when your neck curves in the opposite direction)

This article explains why your neck and spine curve. It talks about what can cause a change in the curvature of your neck, how to treat it, and when you should see a healthcare provider about it.

Why the Spine Curves

Your spine is divided into four curves. You would be able to see the directions in which they curve if you were looking at your spine from the side:

• Kyphotic curves (kyphosis): This is a set of two curves that go backward. You are born with these, which is why they are considered primary curves.
• Lordotic curves (lordosis): This is a set of two curves that sweep forward. These only developed as you began to lift your head and learned to walk. For this reason, they are sometimes referred to as secondary curves.

These curves help balance the spinal column. When gravity presses down on your spine, the curves send the pressure forward and backward. That keeps your spine from being compressed so much by the downward force of gravity.

Flat Neck Syndrome Symptoms

Flat neck syndrome is when the section of your spine that's in your neck (the cervical spine) loses some or all of its forward curve.

This can stretch your paraspinal muscles, which help you lean, bend, and twist your back. It can also affect your suboccipital muscles, which help you turn your neck.

When your neck loses its curve, the muscles at the front of your neck can't be as flexible. Other muscles might be overstretched.

These changes can cause symptoms like these:

• Stiffness in your neck or back
• Limited range of motion
• Pain in your neck, fingers, or toes
• Headaches
• Weaker muscles
• Changes to the shape of your spine

In some cases, the neck moves in the opposite of its natural direction. That's called reversed neck curve.

It's also possible for the joint between the skull and the first bone of the neck to bend forward too much (increased flexion). Too much bending in this spot makes the rest of the spine extend too much as well. This is known as an axial extension.

Axial extension may be helpful if you're temporarily correcting a spinal curve problem, but it isn't good long term. It takes your spine out of its neutral position and allows gravity to compress your spine. If that happens, you may not be able to move as freely. That's partly because your muscles have to work so hard to maintain the position.

Complications

If flat neck syndrome affects the way other parts of the spine curve, a problem known as military back can occur.

This is when the upper back is unusually flat. This condition can compress the spine and cause the bones to be worn away.

In severe cases, flat neck syndrome can lead to paralysis, or the loss of your ability to move. It can also cause you lose control of your bladder and bowel movements.

Causes

Problems with your posture often cause this condition. Some of the other causes of flat neck syndrome include:

• Degenerative disc disease, where parts of your spine wear away over time
• Birth defects
• Spine surgery (iatrogenic injury)
• Neck injury or trauma
• Tumors, infection, or systemic disease

Complications

If cervical kyphosis isn't treated, it may cause more severe problems with your movement, posture, vision, and the health of your spine. It can cause complications like these:

Risk of Injury

Flat neck syndrome can often place too much stress on the nuchal ligament. That's the ligament that limits how far forward you can tilt your head. It is located at the back of your neck, starting at the back of the skull, and extends to the last bone in the cervical spine.

If you have flat neck syndrome, you may be more likely to have an injury. When you can't move as freely, your spine can't absorb shocks as well. Because this condition isn't always painful, you may not be aware of your limitations until an injury actually occurs.

Spine damage

Sometimes flat neck syndrome can even injure the spinal cord itself. If your spine is injured this way, you might notice these symptoms:

• Pain and pressure in the neck
• Numbness or tingling at the base of the skull
• Double vision
• Difficulty swallowing

Dropped Head Syndrome

If cervical kyphosis isn't treated, it can weaken your neck muscles. In some cases, the neck muscles do not hold up your head properly. Your chin tips down to your chest.

This condition is sometimes called dropped head syndrome because of the forward
slump of your head. When your head drops forward, it's not easy to see straight
ahead.

Diagnosis

To find out if you have cervical kyphosis, your healthcare provider will examine your posture, check your balance, and take a look at your ability to move freely.

You might also be asked about whether you had any injuries or surgeries in the past and when you first noticed the problem.

Imaging, such as an X-ray or computed tomography (CT) scan, may be done to confirm the diagnosis.

Treatment

Flat neck syndrome can often be treated successfully using a range of options including these:

Physical therapy

A physical therapist can help you do exercises to correct your posture, strengthen your muscles, and restore some of the curve to your cervical spine.

One exercise that's often prescribed is the cervical retraction exercise. It involves gently tucking your chin down and pulling your neck back in a diagonal movement. It should feel as though you're stretching your neck toward the ceiling in back of you.

Traction

A physical therapist or doctor can also treat your neck with traction. Traction uses a brace, sling, or other device to lift your neck so there's more space between the bones in your spine. That can take pressure off the nerves, too.

Surgery

If physical therapy and traction haven't worked, surgery might be needed if your spine or nerves are being compressed. Surgery's aim is to take the pressure off your spine and nerves, stop your pain, and help you stand, move, and look ahead normally.

To do that, a surgeon might join some of the small bones in your neck with small screws or plates (vertebral fusion).

Another option might be to remove a small section of bone in your neck (osteotomy).

Massage

Massage therapy won't cure military neck. Studies have shown, however, that it can bring you some short-term relief from neck pain. For that reason, it might be a good add-on therapy while you're taking steps to resolve the problem.

Summary

Your neck naturally curves forward. If you're injured or your neck is not aligned properly, that natural curve can flatten out. In some cases, it can even curve in the opposite direction.

If your neck stays that way, it's known as flat neck syndrome or military neck. It can lead to overstretched muscles and ligaments along the whole length of your back and neck. It can also cause your spine to become compressed, which in can wear away parts of your spine. In severe cases, flat neck syndrome can damage your spine.

Flat neck syndrome doesn't always hurt. Even so, it's important to see what's causing it so you can prevent it from getting worse. Physical therapy, traction, massage, and--rarely--surgery may help to correct the curve.