Straight Neck Syndrome aka Loss of Cervical Curve

Military Neck

X-ray view of head, neck and thoracic areas.
Cervical kyphosis is a posture problem that sometimes causes neck pain. Science Picture Co./Collection Mix: Subjects/Getty Images

A normal neck has a gentle curve to it, the degree of which can vary according the the position you are in. But should you lose this curve, through injury, misalignment that is sustained over a long period of time, or for another reason, you may find the rest of your body's posture is affected, too. 

Loss of cervical curve goes by a number of names, including flat neck syndrome, cervical kyphosis, military neck, and when when the reduction in the degree of the curve goes into the opposite direction of normal, reversed neck curve.

While not among the most severe of neck maladies, this condition may affect your well-being in one or more ways.

Spinal Curves — The Abridged Version

Your spine is divided into four curves. When viewed from the side, two curves — often called "normal kyphotic curves," or kyphosis — go backward. These are the curves we're not talking about in this article.

The other two curves sweep forward and are called "normal lordotic curves" or lordosis.

What's the difference between kyphotic and lordotic?

We are born with our kyphotic curves; we develop our lordotic curves as we gain the ability to lift our head and learn to walk. For this reason, kyphotic and lordotic curves are sometimes referred to as primary and secondary curves, respectively.

All curves, including the lordotic neck curve, help balance the spinal column during movement, and protect it from the compressive effects of gravity. In fact, the curves of the spine work together to accomplish this. Carolyn Kinser and Lynn Colby, both physical therapists, and authors of Therapeutic Exercise: Foundations and Techniques comment that flexibility the curves afford counter the compression created by gravity about 10 times more than would a straight spine.

Reversed and Flat Neck Syndrome

Straight neck syndrome, aka, military neck,  is a condition in which the normal lordosis of the cervical spine diminishes, or is even fully lost.

But the loss of curve can go further than that. After the neck curve reaches straight, it may even move into the opposite direction. This condition is aptly named reversed neck curve.

A decreasing lordotic curve is not the only characteristic of flat neck syndrome. Kinser and Colby also report increased flexion, or forward bending, at the joint between the skull and the first bone, which is called the atlas, of the neck. 

The physical therapists add that the excessive bending at this location exaggerates axial extension, or stretching or lengthening through the cervical spine and below.

Amy Matthews, internationally regarded yoga teacher, Body-Mind Centering® practitioner, and author of Yoga Anatomy explains that when a yoga or Pilates teacher gives the instruction to "lengthen your spine," the result is usually axial extension.

But Matthews asserts that axial extension is not always ideal for the body, saying "it's not the most efficient use of the musculoskeletal system. Taking curves out of your posture means your posture no is longer neutral," she explains. 

"In axial extension, there's less movement available, partly because we have to engage the muscles so strongly to maintain it." 

And, a loss of some or all of your cervical curve makes the muscles at the front of your neck less flexible, say Kinser and Colby. The therapists say flat neck syndrome may overstretch certain muscles, for example, levator scaupla or sternocleidomastoid muscle, or both.

Flat neck syndrome can affect the posture in other areas of the spine, as well. Kinser and Colby say that flat neck my accompany another posture problem known as military back, or flat upper back. It may also increase your risk for degenerative changes in the area.

Does Flat Neck Syndrome Cause Pain?

While medical research has yet to confirm whether flat neck and reversed cervical curve are associate with symptoms, especially pain, according to Kinser and Colby, they do.

The duo offers 3 reasons why flat neck syndrome may cause pain:

  1. Your TMJ joint can become dysfunctional based on a habit of keeping mandible (lower jaw) forward as part of the posture.
  2. You may be predisposed to injury because you lose the the shock absorbing function that a healthy, normal neck curve provides.
  3. The condition may put undue stress to a spinal ligament called the ligament nuchae. The ligamentum nuchae helps limit how much neck flexion you can do; it is located at the back of your neck, starting at the back of the skull, and extending to the last bone in the cervical spine, which is often referred to as C7.

A 2005 research study published in the Journal of Manipulative Physiological Therapeutics found that cervical lordosis of 20 degrees or less may be painful, and that chiropractors to treat this condition may wish to target a therapeutic goal of 31 to 40 degrees.

You may be wondering how much pain text neck could cause. Text neck is the prolonged flexed position of the head and neck while interacting with a cell phone. A 2018 study published in the European Spine Journal found that in 18-21 year olds, no pain at all was associated. 

Just the same, text neck represents a deviation from ideal body alignment, and therefore may result in tight or strained muscles, misalignment in other areas of the spine, or an increased risk of injury.


Causes of Straight Neck and Reversed Cervical Curve

Some of the causes of a straight neck and/or reversed neck curve include:

·        Degenerative disc disease

·        Birth defects

·        Spine surgery (called "iatrogenic injury)

·        Neck injury or trauma

·        Text neck, described above.


Treatment for Flat Neck Syndrome

While most of the time, you don't need treatment for a flat neck, many people benefit from chiropractic. Massage, exercise and/or physical therapy may also be helpful. One particular exercise that nearly every health provider who treats this condition gives to their patients is the cervical retraction exercise.

In rare cases — when the spinal cord is disrupted — surgery may be needed. Check with your doctor if you have concerns or questions about your flat neck syndrome and/or cervical kyphosis.

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