By Lee Seung-hon
In the clinic, I often treat patients who complain of chronic neck and shoulder pains. It is more common among office workers who sit at their desks for extended periods of time. In most cases, such patients would be diagnosed with having forward head posture (FHP).
In a normal upright position, the cervical vertebrae (top of your vertebral column) retain a natural curve but in a patient with FHP, the cervical vertebrae are in a straight line. Such a posture alone poses problems as it causes pain, and if left untreated for a long period, it can develop into a herniated cervical disc.
Most of the time, FHP is caused by a bad posture. Sitting at a desk in front of the computer or reading a book in a bad position for hours on end, or sleeping on a highly raised pillow and other bad habits may cause it. Sometimes, whiplash from a sudden impact (for example, a car accident) can also cause FHP.
Our heads are heavier than most think. An adult’s head weighs about the same as a bowling ball, ranging between 4.5 to 6.3 kilograms. Those who have bowled before will know how heavy that is. The fact that our upper body is supporting such a heavy weight is a considerable amount of strain on its own. FHP puts even greater strain on the shoulders. It can be compared to holding a bowling ball on a tilted angle, which is significantly more strenuous than supporting it vertically from underneath. For each 1.27 centimeters the head is tilted forward, the shoulder has to support an extra strain equivalent to a 9 kilogram weight. With such a stress put on their shoulders and necks, patients with severe FHP consistently suffer from chronic tension and pain.
Apart from shoulder and neck pains, FHP can also cause back pain and tension headaches as well as tired eyes. People with FHP can often have rounded thoracic vertebrae, and rounded shoulders. This causes the muscles in the back to tense up. As the cervical, thoracic and lumbar vertebrae that make up the spine are closely connected, many patients with cervical vertebrae issues end up suffering pain in their back, and even their pelvis.
The types of pain caused by FHP are called upper crossed syndrome. Human muscles work in pairs. In order to bend a joint for example, one muscle in a pair contracts while the other part relaxes (straightens). In a patient with FHP, the shoulder trapezius muscles and chest pectoralis muscles are in constant tension, while the inner muscles in the front of the neck and rhomboid and serratus muscles in the back are relaxed and weakened. Therefore, to return to a normal posture, the treatment has to be selective to relax the tense muscles while strengthening the weakened ones.
Simple treatments for FHP can relieve pain but a more permanent treatment should aim to correct the posture to return the forwardly tilted head position to its right state. That will remedy the pain as well as treat the root cause of it. In Oriental medicine, patients with FHP are treated by “chuna,” which is Korean style chiropractic work, acupuncture and cupping. Chuna corrects the muscles and bones that are twisted and knotted. Acupuncture and cupping can be effective for relieving pain and relaxing muscles.
Quite often, patients with FHP choose massage therapy before severe symptoms force them to visit a clinic. At the initial stage, relaxing muscles through massage can help alleviate less severe pain. However, once past a certain stage, it is no longer effective. It is recommended then that the patient is properly diagnosed and appropriately treated to correct their posture at a clinic.
The best way to prevent FHP is by maintaining good posture. Correcting posture can certainly lessen pain and prevent further damage but if the patient maintains bad posture, FHP can recur. The recommended posture to prevent FHP is sitting up straight, while pulling the chin in. If you are at a job where you have to sit at a desk for a long time, it is highly recommended that you take a small break from the desk every hour, and rotate the neck and shoulders. Light stretching is also very helpful.