Abnormal Neck Curvatures Are 18 Times More Common in Chronic Neck Pain Subjects Compared to Non Pain Persons

Abnormal Neck Curvatures Are 18 Times More Common in Chronic Neck Pain Subjects Compared to Non Pain Persons

Chronic cervical spine (neck) pain is one of the leading causes of disability across nations and cultures.

There exists an opinion in the spinal health literature that the presence and extent of the cervical sagittal plane curve (cervical lordosis or neck curve from the side) is unrelated to spine pain conditions and patient health.2 In truth, there are both positive and negative study findings regarding the correlation between spinal pain and the amount and type of cervical spine curvature. However, in this author’s opinion, the number and quality of studies is seemingly weighted on the positive side of the equation; in other words, there is a correlation between neck pain and related disorders and the cervical curvature.3,4,5

Background Data Indicates that Cervical Spine Lordotic Curve Correlates to Neck Pain and Disability
Multiple investigations have been published seeking to understand the association, correlation, or the predictive value of an altered cervical lordosis in neck pain conditions compared to normal controls. One of the most impactful studies in recent years is from Villavicencio et al.3 In their prospective, randomized, double-blind clinical study that enrolled 122 patients, the mean follow-up was 37.5 months. They identified that maintaining a consistent segmental sagittal alignment or increasing cervical lordosis was related to a higher degree of improvement in clinical outcomes as measured with the short-form 36 questionnaire and the neck disability index. Similar findings were identified in the study by Gum et al.4

Figure 1 demonstrates the normal state of the cervical lordotic curvature on the reading left, this person would be expected to have little to know neck related disorders. Then the progressive loss of the cervical lordotic curve is shown in the consecutive images where progressive development of spinal arthritis and disc disease in different patients over time is shown (Levels 1- 4). This figure is based on experimental modeling results in the literature as well as prospectively studies on subjects over time.6

Breakthrough Cervical Spine Study by CBP Researchers

In a breakthrough spine investigation, McAviney and colleagues looked at 277 subjects who were categorized as either healthy controls (99 subjects from a screening) or those who were categorized as chronic neck pain patients (178 from those seeking treatment). Figure 2 demonstrates the location of neck pain, upper back pain, and posterior head pain that was included in this study. Of important note in Figure 2 is that these differing pain sites in patients can be traced in most cases to injury or irritation to the cervical spine facet capsular ligament—joints of the cervical spine.

Several key findings were noted in this important Chiropractic BioPhysics research project:

  • In children aged nine years and up, McAviney et al4 found that reduced cervical lordosis was correlated to the presence of sub-acute and chronic cervico-genic pain. This finding was not age or gender dependent strengthening these findings.
  • Statistically, persons whose cervical spine curves were above 20° were 2 x as likely to be in the normal subject group; conversely those with curves less than 20° were TWICE as LIKELY to be in the chronic neck pain group.
  • Furthermore subjects with a straightened or reversed cervical curvatures were 18 TIMES more likely to be in the chronic neck pain group as compared to the non-pain group.

“Our study is an important contribution to the literature in as much as it is one of the few studies that adequately addressed the relationship between cervical spine pain on one hand and the amount of cervical lordosis on the other with proper statistical methodology. The 20° cervical curvature amount was identified to be the best statistical predictor of which subjects had chronic neck pain vs. who was without pain. This 20° curvature was found to have good sensitivity and good specificity in discriminating between subject groups.” said Doctor Deed Harrison, a senior author of the study.

How Can You Get Help for Your Altered Posture and Spinal Arthritis and Disc Disease and Health Disorders?

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their cervical spines back to health, and eliminate a potential source of progressive SADD, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See for providers in your area.


  1. Noormohammadpour P. Prevalence of Chronic Neck Pain, Low Back Pain and Knee Pain and their Related Factors in Community-dwelling Adults in Iran: A Population-based National Study. Clin J Pain 2016 Jun 1.
  2. Christensen ST, Hartvigsen J. Spinal curves and health: a systematic critical review of the epidemiological literature dealing with associations between sagittal spinal curves and health. J Manipulative Physiol Ther. 2008 Nov-Dec;31(9):690-714. doi: 10.1016/j.jmpt.2008.10.004.
  3. Villavicencio AT, etal. Prospective, randomized, double-blind clinical study evaluating the correlation of clinical outcomes and cervical sagittal alignment. Neurosurgery 2011 May;68(5):1309-16; discussion 1316.DOI:10.1227/NEU.0b013e31820b51f3.
  4. Gum JL, et al. Correlation between cervical spine sagittal alignment and clinical outcome after anterior cervical discectomy and fusion. Am J Orthop (Belle Mead NJ) 2012 Jun;41(6):E81-4.
  5. McAviney J, Schulz D, Bock R, Harrison DE, Holland B. Determining the relationship between cervical lordosis and neck complaints. J Manipulative Physiol Ther. 2005 Mar-Apr;28(3):187-93.
  6. Harrison DE, Harrison DD, Janik TJ, Jones WE, Cailliet R, Normand M. Comparison of axial and flexural stresses in lordosis and three buckled modes of the cervical spine. Clin Biomech 2001; 16(4): 276-284.

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Chiropractic Biophysics Non-profit, Inc. is a 501(c)(3) nonprofit corporation dedicated to the advancement of chiropractic principles through scientific research. Dr. Don Harrison (deceased) and his second wife Dr. Deanne LJ Harrison (deceased) founded CBP research foundation in 1982; it was registered as CBP Non-Profit, Inc. in 1989 by Dr. Sang Harrison (Don’s 3rd and final life’s love). Through this organization Dr. Don and colleagues have published over 300 peer-reviewed spine and Chiropractic research publications. Further, CBP Non-Profit, Inc. has funded many scholarships as well as donated chiropractic equipment to many chiropractic colleges; always trying to support chiropractic advancement and education. Dr. Don Harrison was the acting president of CBP Non-Profit, Inc. since 1982. Currently, Dr. Deed Harrison (Don’s son) is the President of CBP Non-Profit, Inc. Read More

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