Why Poor Posture Causes Neck Pain

By James Fricton DDS, MS

Neck pain is commonly associated with repetitive strain and head and neck postural impairments.

Neck pain is one the most frequent type of chronic pain complaints and is a costly public health issue that is a best addressed early in its onset. While multiple factors may trigger this condition, often its cause comes down to forward head poor posture and tensing the neck and shoulders.

Can Poor Posture Cause Neck Pain?
Poor Posture may Impact your Quality of Life
What are Risk Factors of Neck Pain?
Avoid Acute Neck Pain from Developing
Correct Posture may Reduce Chronic Neck Pain & Neck Disability
Pain Specialists offer Treatment and Preventive Care for Neck Problems
Is Age a Factor in Neck Pain Disability?
- Forward Head Posture
- Upper Cervical Posture
Common Posture Correcting Exercises for Neck Pain
Relationship Between Postural Neck Pain and Disability
How long does it take to fix forward neck posture?

Can Poor Posture Cause Neck Pain?

Yes. Poor posture has been proven to increase people’s neck pain by straining muscles and ligaments that support the neck. Our posture is often assumed without thought. Bad posture may result in neck strain over time. The head-and-shoulders-forward posture is the most common cause of poor posture, which in turn contributes to neck pain.

Poor Posture may Impact your Quality of Life

Poor posture impacts your overall health and quality of life. It is more than how striking good posture looks. Poor posture can trigger back, neck, and muscle pain problems over time. While postural habits – once developed – may be difficult to correct, it is worth the effort because it can both relieve and prevent chronic pain.

Many pain patients discover that the help of a physical therapist can assist in correcting bad posture habits. Patients who experience persistent back or neck pain can find relief when poor sitting and standing posture generate pain. Having your head too far forward often is the root of discomfort.

What are Risk Factors of Neck Pain?

Neck pain risk factors refers to factors such as lifestyle characteristics that increase the possibility of developing chronic pain. When your head poor posture means your head is held forward your cervical spine must support increasing amounts of weight. Over time, this increased stress on the cervical spine can add additional pain and need for medical care.

Pain and impairment of the neck may also affect your motor function, and consequently increase the risk of falling and fractures.

The cause of neck pain is commonly not due to underlying disease but rather strain to the muscles and joints. Your risks of developing this painful condition increases with prolonged or repetitive strain (whether looking up or down). It may also be due to sleeping poorly or in the wrong position, stress that causes tensing, or even often wearing heavy necklaces or having long hair.

Some lifestyle factors that increase neck pain risks are:

Repetitive computer use.
Slouching during prolonged sitting.
Tensing the shoulders (May be tension caused by anxiety or depression).
Forward head posture during cell phone use.
Clenching and grinding of the teeth.
Longer work hours that mean fewer breaks from sitting.

How to Avoid Acute Neck Pain from Developing?

Things you do daily that protect your neck, which include gentle stretching exercise, and balanced relaxed posture. The balance between risk factors and protective factors can prevent neck pain progression. Individuals who text a lot and/or pay games on their mobile phone or computer for hours a day, may later experience pain. Others may find that hunching over a workbench puts their neck in a vulnerable position. Prolonged periods of neck inflection may influence your risks of worsening neck pain.

“Psychological (e.g. psychosocial stress, anxiety, and depression) risk factors, such as long-term stress, lack of social support, anxiety, and depression are important risk factors for neck pain. There is more evidence for some risk factors, such as lack of physical activity, duration of daily computer use, perceived stress and being female.” – Neck pain: global epidemiology, trends and risk factors NIH article ^[1]

Correct Posture may Reduce Chronic Neck Pain & Neck Disability

Consider how much time you spend sitting in front of a computer. The National Institutes of Health (NIH) recognizes how musculoskeletal pain represents a major public health problem. A significant relationship was observed between the level of physical activity practice and a person’s Body Mass Index (BMI). It’s Oct 14, 2022 “Physical activity, sitting time, neck disability and posture in workers using visual display terminals (VDT)” article concluded that “The increase in sitting time produces an increase in neck disability among workers.

The promotion of exercise enriched leisure-time and the reduction of prolonged uninterrupted sitting time at work may reduce musculoskeletal issues. Your pain clinic may assess your postural situation by utilizing Posture Assessment Software (PAS/SAPO) among other techniques.

Pain Specialists offer Treatment and Preventive Care for Neck Problems

Their goal is to reduce your discomfort and prevent chronic pain. The specialist’s examination assesses your pain, characteristics and individual outcomes to establish a physical diagnosis. This may include tips on how to correct your poor posture.

Risk factors that may lead to chronic pain:

Level of neck pain.
Level of range of motion and tenderness.
Quality of life (QoL) and disability scores.
Ensuing behavioral and psychosocial factors.
Impact on physical function (muscle strength, mobility, and endurance).

Poor posture adds muscle strain on the neck. It may results in the diagnoses of myofascial pain and/or muscle spasms. Myofascial pain is characterized by tender muscle knots called trigger points that cause both pain over the muscle and referred pain to adjacent areas such as headaches.

These can be reversed by gentle stretching and correcting your routine posture to balanced and relaxed. Other times, the pain may be caused by an underlying neck problem, such as spinal stenosis, arthritis, or disc degeneration. It can be triggered from trauma to the neck such as whiplash but frequently occurs insidiously, or for no obvious or identifiable reason.

Is Age a Factor in Neck Pain Disability?

Yes. Increased age can contribute to neck pain and disability. It typically occurs with forward head posture and upper cervical posture.

Forward Head Posture

NIH conducted a systematic review of what role a person’s age has when assessing the relationship between forward head posture (FHP) and neck pain. The results showed it has a confounding impact and that older adults with neck pain show increased FHP when compared to asymptomatic adults. FHP is significantly correlated with neck pain measures in adults of all ages, but specifically the older adult population. It is the most common cervical postural fault. No relationship is reported between FHP and most of neck pain measures in adolescents. It’s different pain severity levels signal that establishing healthy posture early in life has long-term benefits.

The December 19, 2021 “Relationship Between Forward Head Posture and Neck Pain” report states that “Eight studies showed significant negative correlations between FHP and neck pain intensity (r = − 0.55; 95% CI = − 0.69, − 0.36) as well as disability (r = − 0.42; 95% CI = − 0.54, − 0.28) in adults and older adults, while in adolescents, only lifetime prevalence and doctor visits due to neck pain were significant predictors for FHP.”

Upper Cervical Posture

Upper cervical posture (UCP) is often measured by the angle between a person’s ear lobe and eyes. This e horizontal line (or its complementary angle) reflects the posture of the upper cervical spine. It is also known as “gaze angle” or “sagittal head angle”. Neck pain subjects that have been studied across a broad age range (adolescents, adults, and older adults) find a lower relationship between head posture and neck pain in younger individuals than seniors.

Both forward head posture and upper cervical posture in adults with neck pain may find it is attributed to a flexed posture (FP) versus correct neck alignment. Younger individuals, when performing the same tasks, commonly have more dexterity, strength, and fewer years where stress, repetitive tensing, and injury may build up and trigger neck pain. Maintaining a high flexion angle of the neck during daily tasks tends to increase the weight of the head. It’s like holding a bowling ball with the neck. In turn, this puts extra load on the neck muscles and spine, leading to more neck pain.

In this way poor posture leads to changes in a person’s ligaments, tendons, and muscles which may progressively cause permanent changes in head and neck posture that impacts how the neck is supporting the head. Healthy ligaments, tendons and muscles, commonly referred to as the soft tissues, in and around the cervical spine (the neck) are vital to maintaining correct posture and preventing TMJ neck pain.

FP is characterized by the head protruding forward and, eventually, an increased thoracic kyphosis (TK) and more myofascial neck pain that needs releasing. Simply stated, TK refers to the excessive forward curvature of the spine in the upper back. Correcting your posture earlier in life may spare you from this painful condition. A long-term stooped forward posture can cause neck pain from mild, requiring no treatment, to severe chronic pain symptoms that are best treated with professional guidance of a pain specialist and physical therapist.

What is the Treatment for Neck Pain Associated with Poor Posture?

A physical therapist can assist a person by identify incorrect posture issues, how to improve alignment, and provide neck-strengthening exercises.

Common posture correcting exercises for neck stiffness and pain:

Sitting posture: Sit with bottom back against chair then lean back with head up and back while balanced and relaxed over the neck. The shoulders should be relaxed and down.
Standing posture include: Chest up, head up, balanced over the neck, and shoulders relaxed back and down. Be mindful of maintaining balanced relaxed postures during the day. Avoid forward head position.
Neck stretches: Start by gently turning your head to the right and lower your left ear towards your left shoulder; take your left hand and pull down gently to maintain this position for 5 to 10 deep breaths. Next, repeat process over your right shoulder by turning your head to the left and lower right ear towards right shoulder and gently pull down to the point of pain with your right hand.
Neck rotations: At a slow and steady pace move your chin towards your left shoulder; hold for approximately 10 seconds, then repeat on opposite side.
Switch this exercise between standing and sitting: tuck your chin in using a gentle pressure by two fingers of one hand. Place your other hand on top of your head, and slowly push as you draw your head toward your chest until you feel a stretch. Hold this position for 20-30 seconds. Return to your normal chin position; repeat 3x times.
Check with your physical therapist about adding Thoracic Spine Foam Rolling and Upper Trapezius Stretching exercises.

Avoid Tensing Habits. Remind yourself regularly to identify any tensing habits. Use reminders such as stickers or timers. If noticed, replace negative habits with positive habits. This means checking to se if you have your head up, chest up, chin in, shoulders relaxed and down.

Problem posture related activities to avoid:

Shoulder shrugging and tensing.
Tensing your neck and jaw.
Sleeping on your stomach.
Neck strain from typing & computer use.
Forward head posture with texting.
Bracing the phone between ear and shoulder.
Slouching while sitting in a chair.
Carrying heavy purse/backpack on one shoulder.
Turning head to one side for hours with screen.
Rounding shoulders down and forward.

On your own, set your computer monitor at eye level to ease neck strain. You can do this by first sitting comfortably in front of your computer and close your eyes. Next, open them, note if your gaze is directly in the top-third of your computer screen. This is where it should be. If you find you need to look downward, then raise your monitor up. Laptops frequently require you to tilt your head downward to see the screen. Try connecting your laptop to a separate monitor, or screen at the right level. Or create a “stand” for your laptop, to position it correctly.

Tensing your neck and jaw can cause additional pain and possibly contribute to locked jaw issues.

Relationship Between Postural Neck Pain and Disability

Many burgeoning pain disorders can be averted. Another NIH December 2017 Relationships among head posture, pain intensity, disability and deep cervical flexor muscle performance in subjects with postural neck pain study, assess neck pain intensity and disability.^[2]

Tools used to measure impairments from postural neck pain
S. No.	Variables	Measurement tools to be used
1	Intensity of neck pain	Visual Analogue Scale
2	Neck Pain Disability	Northwick Park Neck Pain Questionnaire
3	Head posture (expressed in cranio-vertebral angle)	Modified Head Posture Spinal Curvature Instrument
4	Deep cervical flexor muscle performance (expressed in Performance index)	Stabilizer Pressure Biofeedback Unit

The above NIH study results on postural neck pain management suggest two means of treatment:

It is essential to adjust poor head posture through appropriate therapeutic interventions.
In addition to the routine application of pain-relieving modalities, a suitable exercise regimen that exclusively targets the deep cervical flexor muscle to improve its endurance is warranted.

How long does it take to fix forward neck posture?

Most pain patients find that after thirty days of posture exercises, they can make a significant difference in improving posture and lowering neck pain. Medical research indicates that it takes 3 to 8 weeks to establish an exercise routine. Meaning, each person’s dedication and ability to follow-through impacts how long it takes to fix neck posture. They key is maintaining life-long healthy posture habits.

Posture correction and care may include a review of possible underlying conditions, decompression therapy, and home exercises to gradually correct any postural issues. Each person is unique, so a thorough initial office exam and diagnosis is best to determine a baseline before proceeding with treatment.

A clear definition/standard for neck pain severity (mild or moderate), duration (acute or chronic), and frequency that is accepted widely by pain clinics will help.

Now you Know Why Poor Posture Causes Neck Pain

Our staff can help determine severity and functional impairment due to neck pain and how to improve this with treatment and self-care training. A pain specialist and/or a physical therapist at a MN Head & Neck Pain Clinic can create your personalized routine. It will focus on how to stretch and strengthen your neck muscles, improve posture, and alleviate your associated symptoms of neck and shoulder pain and discomfort.

Contact us today to schedule your neck pain diagnosis and consultation.

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About the Author

James Fricton DDS, MS is a leading pain specialist at the Minnesota Head and Neck Pain Clinic, Chair of the Specialty Committee for the AAOP, and University of Minnesota Professor Emeritus

References

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725362/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694898/

Poor Posture Causes Neck Pain