The curse of the straight neck aka loss of lordosis

As a chiropractor in Singapore, I work a lot with neck pain patients. The unfortunate truth is that neck aches and soreness are often poorly managed in Singapore and most patients don’t get long term relief.

You have probably tried various treatments. You may have even seen chiropractors who specialise with neck problems to no avail. The reason is simple: You did not receive evidence-based care.

What is a straight neck?

Most people consider a c-shape neck to be the most healthy. This c-shape curvature is referred to as lordosis. Virtually all textbooks would print a c-shape spine as the default “correct” neck position.

The leftmost image is a textbook “perfect” cervical spine. It has a c-shape curvature and is considered to be healthy. In the middle, we have a straight neck or sometimes also referred to as military neck. Radiologists often report this as “loss of cervical lordosis” in their x-ray reports. The rightmost image shows a kyphosis or a reversal of the c-shape.

What is normal neck curvature?

There is so much emphasis on neck alignment that we have chiropractors that specialise on treating the neck. The most obvious would be the “upper cervical chiropractors”. Not only do they focus on the neck, they specifically focus on two bones — the atlas and the axis, also referred to C1 and C2.

Their reasoning is that because the C1 and C2 sits closest to the brain and has the most innervation compared to the rest of the spine, they are the most important places to focus on. While this type of narrative may sound riveting, there’s no credible scientific studies to support their claim.

Because everyone keeps talking about neck problems and neck misalignment, we forget to ask ourselves what actually is considered normal.

The truth may surprise you: Loss of cervical lordosis and a kyphotic cervical spine are both not associated with neck pain. In fact, there’s little to no evidence to suggest that’s bad for you!

Study 1: No association between cervical spine curvature and neck pain

The authors examined 107 volunteers and found no relationship between neck pain and spinal curvature. They look at both segmental angles (i.e., angle between one neck vertebra and the next) as well as the general curvature of the entire neck and found that it’s not related to:

• How much pain a person has
• How often the person experience pain
• How long does their pain last for
• Whether there is radiating pain or sensory/motor issues
• Degree of disability experienced
• How often they seek help

So ya, it’s pretty hard to accept that a straight neck is bad for you when there really isn’t any decent quality studies to suggest it. If we were to guess, the “straight neck” narrative is probably used as a fear mongering technique to get pain sufferers to buy expensive packages.

Study 2: No difference in neck pain across different neck alignment

This study has a whopping 323 participants! It’s considered a big sample size and is pretty impressive. When the researchers compared neck pain sufferers versus those without neck pain, they found no difference in neck curvature. That is, people with a straight neck are no more likely to experience neck pain. Similarly, people with the so called textbook “perfect” pain are not less likely to have neck pain.

Interestingly enough, it’s also not associated with age or BMI. So if you think you are having neck pain because you are getting older, that’s simply not true. If you think you are experiencing neck pain because you are overweight, that’s also not true!

What the authors did find is a relationship between neck pain and arm pain. They also found differences in physical function and disability. In essence, neck pain affects your ability to live your life to 100%.

Well, that makes sense right? I am sure you have experienced times when your neck aches and soreness is just so intense that you cannot focus? Perhaps to the extent that you need to lie down to rest?

We like to think that pain is just pain. It’s all in the mind and as long as can tahan equals life is all good. Well, that’s certainly not true. It affects our quality of life. Not only that, it also affects our work performance.

Neck pain treatment in Singapore

According to the latest research, exercise is your best bet when it comes to chronic neck pain. Sure, you may ask if exercise is part of chiropractic.

The answer is yes!

Exercise is a big part of chiropractic since the very beginning. Early chiropractors used exercise to help patients achieve alignment of their spines. What we are doing at our practice is 100% part of chiropractic.

Unfortunately, many chiropractors in Singapore choose to not offer exercise as part of their treatment approach. The reason is because exercise as a treatment takes consideration longer time than just a five-minute full spine adjustment.

Furthermore, the relief from getting cracked is fairly short. Research suggests that it lasts for only 30 minutes. Many chiropractic patients will experience relief for a couple of days at most. This means they will need regular treatments. For this reason, choosing to mainly offer spinal adjustments is good for business! You have to keep coming back for more!

With the growth of science and research, we starting to learn more about body, and what actually helps with recovery. Both chiropractors and pain patients alike would have to keep up in order to achieve good outcomes. Yes, all of us have our own biases, beliefs, values. We are not denying that.

What we are saying is that, at some point, all of these have to go if we want good outcomes. We have to keep up with times. Especially if you are not getting better.

Have a think about it. You can’t keep doing the same thing and expecting a different result. What you need for extraordinary results is a radical change. This can start with the type of treatments you choose.