With the rise of smartphones and social media apps that keep users glued to small screens for hours upon hours, forward head posture is becoming more common. Unfortunately, this postural fault can set the stage for neck pain. In fact, it’s estimated that up to 60% of patients with neck pain exhibit forward head posture. Let’s look at why this is the case and what chiropractic care can do about it.

The average human head is about the same size and weight (~12 lbs) as a bowling ball. The cervical spine and all the muscles and tissues in the neck have evolved to support the head so that it rests directly above the midline of the body. When the head sits forward of its normal position, either from learning in or looking down (or both), the muscles in the back of the neck, shoulders, and upper back must work harder to hold it upright. Studies have demonstrated that forward head posture increases the load on the muscles attached to the back of the neck by nearly four times! You can experience this for yourself by holding a weight close to the body and then holding the same weight with the arms extended. Over time, the normal C-shaped curve of the cervical spine can straighten or even reverse, leading to degenerative changes in the joints and intervertebral disks. These adaptations to facilitate looking down at a device both lead to neck pain and disability and increase the risk for musculoskeletal disorders in adjacent parts of the body as they too may develop abnormal biomechanics.

When a patient presents for care at a chiropractic clinic for neck pain accompanied by forward head posture, the first order of business is to review the patient’s history and conduct an examination to help establish a treatment approach. The specifics of a care plan will vary from patient to patient but will likely include both manual therapies provided in the office to facilitate normal joint motion and exercises to perform at home to help correct posture. In addition to manual therapies like spinal manipulation and mobilization applied to the cervical spine, patients may also receive therapies to address trigger points in the muscles of the neck and upper back, adjustments to the thoracic spine, scapular stabilization exercises, and more.

While chiropractic care can help manage neck pain and other symptoms associated with forward head posture, maintaining these benefits over time will require lifestyle changes. A 2021 study found that using a smartphone an average of seven hours a day or more can increase the risk for neck pain by 80%. An experiment conducted in 2021 revealed that two-thirds of adults will experience neck and/or upper back pain from just 30 minutes of smartphone use with sustained neck flexion. Reducing smartphone use is important, and when you must use a device, try holding it at eye level so the head can remain in a neutral position. Additionally, get regular exercise as the stress of movement is how the joints in the body (including those in the neck) are nurtured and hydrated. Since low grade inflammation in the body may increase the risk for neck pain, get plenty of sleep, manage stress, and eat more fruits and vegetables (and less processed food).