Hyperkyphosis and its Effects on Neck Pain and Sensorimotor Control

By: Deed E. Harrison, DC

Thoracic hyper-kyphosis, or excessive curvature of the middle spine, is a common yet often overlooked contributor to neck pain, neck disability, and sensorimotor control measures. In general, sensorimotor control is a fundamental function of your nervous system to take all the sensory input from the environment (sight, sound, taste, touch, smell, position sense) and filter it to relevant information and process it in the motor control system to create a motor output (an action or movement); this process underpins a person’s potential to interact with and experience the environment they live in. For those suffering from non-specific chronic neck pain, hyper-kyphosis can significantly impact their daily lives. However, the relationship between hyper-kyphosis and these neck issues has not been fully researched in treatment or case control studies. In this case control design, we will delve into the effects of hyper-kyphosis on neck pain and sensorimotor control.

The study compared 80 individuals with hyper-kyphosis, defined as a thoracic curve greater than 55 degrees, to 80 individuals matched for age and neck pain duration but with normal kyphosis. The hyper-kyphosis participants were further categorized into two groups: postural kyphosis (PK) and Scheuermann’s kyphosis (SK). The Student’s t-test was used to compare the means of continuous variables between the groups.

The results showed statistically significant differences between the hyper-kyphosis groups and the normal kyphosis group for all the sensorimotor measured variables, and correlation coefficients were used to assess if the relationship between kyphosis magnitude is correlated to the magnitude of increasing pain, disability and worsening of sensorimotor control measures.

SK had the most decreased efficiency of measures in the hyper-kyphosis group. Interestingly, there was a significant difference in neurophysiological findings for skin sympathetic resistance response (SSR) amplitude, which is a measurement of the flight or fight response of the autonomic nervous system, ​​including the ability of your eyes (movement) to track an object in space (called SPNT), balance and stability using a balance plate, and the ability of a person to reposition their head accurately in space. There was no significant difference for SSR latency (p = 0.07).

Implications

These findings suggest that hyper-kyphosis, especially Scheuermann’s kyphosis, can significantly impact sensorimotor control measures in individuals experiencing non-specific chronic neck pain. As a result, addressing thoracic hyper-kyphosis should be considered in treatment for neck pain.

Furthermore, posture education and intervention may be beneficial for individuals with postural hyper-kyphosis. Postural hyper-kyphosis can sometimes be corrected with postural education alone, which can be essential to preventing further curvature and avoiding more severe spinal problems in the future.

It should be noted that this study had a few limitations, including the fact that it only focused on individuals with non-specific chronic neck pain. The study introduced the importance of standardized, objective measures, which were not utilized as much in the past.

Takeaway

Hyper-kyphosis is a crucial, yet often overlooked, aspect of neck pain and sensorimotor control measures. More research is necessary to better understand the effects of hyper-kyphosis and how they can be treated.

The findings from this study suggest that addressing thoracic hyper-kyphosis should be considered in treatment for non-specific chronic neck pain, especially in those with Scheuermann’s kyphosis. Posture education and intervention may play a significant role in managing postural hyper-kyphosis to prevent further curvature. Overall, it is critical to gain a greater understanding of hyper-kyphosis and its implications for neck pain and sensorimotor control measures to improve treatment options in the future.