A manual therapy approach to the neck pain due to abnormal head position

Abstract

Introduction. Neck pain (NP) is an increasingly common symptom among the general population, regardless of age, but predominantly in women. Most studies confirm the direct links between this symptom and the biomechanical changes in the cervical spine, induced by postural problems. Objectives. To identify the mechanisms of maintaining the cervical symptoms in patients with abnormal head position, as well as the benefits and limitations of manual therapy for these dysfunctions and also to suggest and develop complementary or substitutive solutions to the used therapies. Methods. 51 patients were included in the study. We used the Assessment Card for the Patient with Cranio-Cervical-Mandibular Dysfunctions, the Visual Analog Scale, the Cervical Flexion-Rotation Test, Rocabado’s, Romberg’s and Fukuda’s functional tests, Kirby’s and Root’s Biomechanical Foot Assessment Cards, Static and Dynamic Computed Baropodometry, Palmerini’s Cranio-Cervical-Mandibular Functional Assessment and the Visual Acuity Difference test developed by Giannelli. Results. The total extinction of the NP was found in 49% of the subjects, the stabilization of the upper cervical spine in 64.7% of them, while 56.8% of the patients of our study neglected to treat the primary extra vertebral cause of their cervical instability. Conclusions. Removing the extra vertebral factors that cause head position changes and implicitly NP, followed by cranio-cervical-mandibular manual therapy, results in significant improvement in the postural syndrome and the reduction of the painful symptoms.