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Cervical Postural Syndrome

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Cervical Postural Syndrome (aka Postural Prolapse Syndrome)

Dr. Todd Huffman

McKenzie Pediatrics

2024

The cervical spine refers to the top part of the spine or what you would think of as your neck.

Cervical postural syndrome then simply refers to a condition where one adopts poor posture of the neck which often occurs in combination with (or eventual development of) poor posture of the shoulders, upper back and middle back.

Although poor posture can look different on different people, typically cervical postural syndrome is associated with forward head posture (aka forward head position) where the head and neck lie in front of the trunk. Forward head posture often goes hand in hand with a protruding chin, rounded shoulders and increased curvature in the upper back.

Chronic headaches, neck pain/strain, upper and lower back pain, and reduced lung function (what is known as vital capacity) can result. Over time, a person with postural prolapse syndrome can develop a reduced vital capacity (and thus reduced oxygen delivery to the body) by 30%, the equivalent of living every moment at 11,000 feet in altitude.

When you are in an optimal posture the load of your head and the force of upper body movements are evenly dispersed through your spine and the muscles of the head, neck and shoulders. You can only imagine that sustaining positions of poor posture can lead to muscle imbalances and place excessive load on specific soft tissues, joints and bones of the head, neck and upper back. Over time, this can lead to tissue damage and signals of pain to alert the body of this dysfunction. Postural prolapse syndrome is a leading cause of chronic pain syndromes.

What are Risk Factors for Postural Syndrome?

Individuals who spend a lot of time in one specific position or posture are at the highest risk of developing cervical postural syndromes. It can become tiring to stay in one position for a long period of time and when our muscles get tired, they adopt other positions that are not always ideal. We tend to fall into positions where the bones and joints are left to bear the forces imposed instead of the muscles. These positions are not ideal and lead to postural syndromes.

Individuals who are generally sedentary, with little to no physical activity, are also at risk for postural syndrome. Humans evolved as a species constantly in motion, but in today’s world many children and adults spend most of their time inactive.

Those who are particularly at risk include individuals who spend a great deal of time focusing on something in front of them or below their line of vision such as people that sit in front of a computer, spend hours reading, studying or driving. This also includes individuals who spend countless hours browsing on their tablets and/or smartphones. In addition, everyday activities that require both arms to be working in front of the body, such as cooking, cleaning and gardening to name a few, can also be particularly taxing on our posture.

In sport, the same principles apply. Athletes are at risk of developing postural syndromes if their sport requires them to maintain a position for a prolonged period. Cyclists are a specific population that fall in this category.

What Causes Cervical Postural Syndrome?

This question ties into the last. Cervical postural syndrome is caused by poor postures that are sustained for long periods of time. Over time, the body adapts to bad posture. There can be changes in length of some of our muscle groups, activation of some muscles becomes inhibited while other muscle groups can become more dominant ultimately causing muscle imbalances. This can also lead to changes in boney alignment and added strain on structures such as the joint, tendons, discs etc. Our body tissues can only take so much. You may not feel any discomfort at first when you adopt poor postures but eventually, when you have exceeded the tissue capacity for strain, pain will develop.

What are the Symptoms of Postural Syndrome?

Symptoms can vary between individuals. The most common complaint is a dull ache or burning pain in the neck, mid to upper back and/or along the tops of the shoulders. Occasionally, individuals may complain of headaches.

Generally speaking, the symptoms are provoked when individuals are in the faulty posture and tend to improve once they correct their posture or change positions.

Treatment for Postural Syndrome?

Cervical postural syndrome is best managed by improving postural imbalances through an individualized corrective exercise program, manual therapies, ergonomic adjustments, and lifestyle changes. A skilled physical therapist, physiotherapist, and/or chiropractor can work with your child to develop an individualized treatment program that will be targeted to your specific needs.

Full recovery can take anywhere from 4 weeks to 12 months. Keep in mind that your child will need to make dramatic (and hopefully lasting) changes in muscle flexibility, strength and endurance which takes time and commitment to a regular exercise program. To speed up your recovery and prevent future re-aggravation, your child will need to make permanent adjustments to their posture and modify any activities (such as greatly reducing screen time) that provoke their symptoms.