The impact of forward head posture on neck muscle endurance and thickness in women with chronic neck pain: a cross-sectional study

Abstract

Abstract Background Forward head posture (FHP) is a common postural deviation that has been linked to neck pain and dysfunction. The impact of FHP on neck muscle endurance and thickness in individuals with chronic neck pain remains unclear. This study aimed to compare neck muscle endurance and thickness between women with chronic neck pain and FHP versus those with chronic neck pain but normal head/neck posture. Methods Forty women with chronic non-specific neck pain were divided into two groups based on craniovertebral angle assessment, 20 with FHP and 20 with normal posture in each group. Neck pain, disability, neck flexor and extensor muscle endurance, and neck muscle normalized thickness (sternocleidomastoid, upper trapezius (Utrap), longus coli and total neck extensors) measured via ultrasound were compared between the groups. Results Women with FHP demonstrated significantly lower endurance of the extensor muscles, normalized thickness of the Utrap muscle, and significantly higher Neck Pain and Disability Scale (NPDS) and Neck Disability Index (NDI) scores compared to the Non-FHP group (p < 0.05). Craniovertebral angle (CVA) was positively correlated with extensor muscle endurance (p = 0.002, r = 0.481). Conclusions Our findings indicate that the endurance of neck extensor muscles decreases, and neck pain and disability increase in women with chronic neck pain and FHP. This emphasizes the importance of addressing FHP in patients with chronic neck pain and considering the improvement of neck extensor muscle endurance as part of their treatment. These findings may also serve as indicators of the severity of neck pain and assist in patient monitoring.

Keywords

• Forward head posture
• Muscle endurance
• Muscle thickness
• Neck pain
• Ultrasonography