The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis

Purpose of Review Forward head posture (FHP) is the most common cervical postural fault in the sagittal plane that is found with different severity levels in almost all populations. Despite claims that FHP may be related to neck pain, this relation seems to be controversial. Thus, our purpose is to...

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Bibliographic Details
Published in:	Current reviews in musculoskeletal medicine 2019-12, Vol.12 (4), p.562-577
Main Authors:	Mahmoud, Nesreen Fawzy, Hassan, Karima A., Abdelmajeed, Salwa F., Moustafa, Ibraheem M., Silva, Anabela G.
Format:	Article
Language:	eng
Subjects:	Hot Topics Medicine Medicine & Public Health Minimally Invasive Surgery Orthopedics Rehabilitation Medicine Sports Medicine Surgery Surgical Orthopedics
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Summary:	Purpose of Review Forward head posture (FHP) is the most common cervical postural fault in the sagittal plane that is found with different severity levels in almost all populations. Despite claims that FHP may be related to neck pain, this relation seems to be controversial. Thus, our purpose is to determine whether FHP differs between asymptomatic subjects and those with neck pain and to investigate if there is a relationship between head posture and neck pain. Recent Findings A total of 15 cross-sectional studies were eligible for inclusion for this systematic review and meta-analysis. Ten studies compared FHP between a group of asymptomatic participants and a group of participants with neck pain and an overall mean difference (MD) of 4.84 (95% CI = 0.14, 9.54), indicating a significant between-group difference, contrary to adolescent (MD = − 1.05; 95% CI = − 4.23, 2.12). 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. Summary This systematic review found that age played an important role as a confounding factor in the relation between FHP and neck pain. Also, the results showed that adults with neck pain show increased FHP when compared to asymptomatic adults and that FHP is significantly correlated with neck pain measures in adults and older adults. No association was found between FHP and most of neck pain measures in adolescents.
ISSN:	1935-973X 1935-9748 1935-9748