Is "forward-head posture" really a problem? (chiropracty)

I was flipping through youtube videos and saw several alarmist videos about the problem of forward-head posture caused by working on a computer (or poor posture in general). It was talking about how the neck vertebrae get fused in a hunched position, which causes all manner of horrible pain. Is this just propaganda to get more people to visit a chiropractor, or is it a real problem?

Vertebrae don’t fuse from simply being in one position for a long time…that’s not how bones, cartilage, etc… work.

I took a quick look at some videos (well…I looked at the search results, good enough) and it all seems like BS to me. Most of the videos were from website that were probably trying to sell you something, with names like, or, etc…

Essentially, if it’s related to chiropractic, it’s probably BS and a scam.

Yeah, I dunno about the fused vertebrae thing.

It is certainly true that forward-head posture is not good for you, but more because you strain muscles that aren’t supposed to be holding your head up (and aren’t built strongly for that) and weaken the muscles that are supposed to be (so they can’t do their job as well). And you may pinch nerves as well. At least, that’s what my physical therapists say.

My husband has fused vertebrae in his neck - from surgery, and it involved metal rods, mesh, screws, and cadaver bone, all installed by an orthopedic surgeon. I spend way more time on the computer than he does, and while I sometimes get a stiff neck, nothing is fusing.

And I’d say that even if I didn’t think chiropractors have far too many quacks and idiots in their ranks.

What is this “forward head posture”? It doesn’t seem part of the reality of working at a computer.

And yes, the neck vertebrae fusion thing is nonsense.

I suppose it’s possible that remaining in a fixed position for long periods could result in muscle strain/aches which might feel better with physical therapy. But mostly this smells like another attempt to convince people that their bodies are too weak to withstand normal activities of daily living and they need to consult some sort of therapist or buy certain products to solve the imaginary problem(s).

It’s definitely a problem for me, and has caused a good deal of back pain. Next week I’m going to see a massage therapist for it, so we’ll see if it will be a miracle cure or snake oil. I’ve got my fingers crossed but am prepared for anything.

Good question and glad someone asked. Forward head posture (FHP) exists when the head (weighing approximately 10 Ibs) comes out of alignment with the shouders. Dr Rene Cailliet, American born physician and pioneer in physical rehabilitation well known for his books on musculoskeletal medicine states:

“You can realign your entire body by moving your head … your head held in a forward position can pull your entire body out of line.” He goes on to explain that the vital lung capacity is reduced as much as 30% with forward head posture.

I see FHP every day in private practice. As the head moves forward, its weight increases and over time continues to pull the head further forward due to gravity. Early symptoms of FHP can be: no symptoms, muscle tension, headaches (I had 5 years of almost daily headaches and that is what got me into chiropractic to begin with) etc.

As one ages and the head travels further forward, the stress to the joints and tissues (muscles, bones, joints, vertebral discs, arteries, nerves) can and often does lead to osteoarthritis (better known as ‘wear and tear’). This occurs because of **Wolff’s Law **(a well known science theory that says that when bone is under stress and strain, as with FHP, the bone will start to remodel…ie:arthritis).

It is sad that by the time many patients come to see me the FHP has developed so far that the ‘wear and tear’ may already be severe and in extreme cases (I have had two in the last 6 months) the lower vertebrae were under so much stress from the amount of FHP that they had fused together.

My suggestion, is that if you have FHP (as I did twenty years ago, causing me daily headaches) get it seen to now while the corrective exercises are still relatively easy to do. This is what my FHP looked liked only just 6 years ago:I hated my posture

Eh? Where does it get the extra material from?

I think having one’s head too far forward habitually causes trouble. While I was doing it, to look closely through my bifocal adds at the computer screen, my deteriorating neck became so painful I would up getting the bottom half fused surgically.

That said, there are some pretty odd statements in some of the quotes and references here. Unfortunately people whose spines hurt are pretty motivated to seek help wherever it looks like they might find it, even if they don’t have the kind of professional skill to sort through the nonsense.

I think reputable orthopedic surgeons who specialize in the spine, as well as physical therapists likewise, do have some reliable information and genuinely helpful services to offer. But it seems like kind of a free-for-all out there, sadly.

An interesting claim - but where is the evidence to back it up?

I looked through literature reviews in the Pub Med database and while the term forward head posture turns up in varying contexts, I do not see any research documenting that such a posture developed through normal work activities causes vertebral fusion, marked lung capacity as described or other such anomalies.

This makes no sense - how can a body part’s weight increase due to the manner in which it is held?

Your evidence for this is?

How do “lower vertebrae” manage to fuse based on how the head is held?

The Wikipedia article you link to says nothing about arthritis. It says that bones subjected to greater stresses will get stronger, and bones subjected to less stress will get weaker. As far as I know, that doesn’t have anything to do flexibility or pain.

I’m a licensed massage practitioner. Forward-head posture is definitely a real condition, and can definitely cause headaches, backaches, pain, and nerve damage if it gets bad enough. I’ve never heard of it causing vertebral fusion, but that’s not my department.

Basically, the structure of the human body works great if we use it for what it was built for, which is running around barefoot, walking upright, moving our bodies in all sorts of the ways it can. Everything stacks up nicely and the head rests on top of the cervical vertrabrae and spinal column and everything’s hunky-dory (I know, I’m exaggerating for effect.)

But when you do what most of us are doing right now, which is slump down in your seat looking at a computer monitor that isn’t perfectly ergonomically lined up right in your line of sight when your head is being held high and erect and balanced just right on top of your neck … stuff happens.

What kind of stuff? Shortening of the scalenes (which are some of the key muscles connecting your neck and jaw to the top of your ribcage), overstretching of the muscles, and ligaments in back. You know how your grandma used to tell you “If you keep that up your face’ll stick that way”? Well, in this case, it kind of does. If you habitually keep a muscle in a shortened position, eventually it’s gonna want to stay that way.

I guess I could see vertebral damage happening of the condition where advanced and chronic enough. “Bone is living tissue and remodels to the stresses placed upon it.” (One of the mantras we learned in massage school.)

When PostureVideos said:

I assume what s/he meant was that once you’ve tilted your heavy ol’ head that far forward, you’re asking muscles that weren’t designed to hold up a head at that angle to work much harder than they’re used to. I’m lousy at physics, but I dare say you’ve got an effectively heavier head once it’s tipped off balance (at least as far as your trapezius and splenius capitus are concerned).

As far as chiropractic goes, there are some really truly good and effective chiropractors who are very smart, savvy, and really provide excellent back care. But, as my massage instructor used to say “About 5% of chiropractors know what they’re doing and are good. The rest are quacks.”

Well, at first, I was like, “Hmm, someone named “PostureVideos” comes in to claim that something everyone else thinks is quackery chiropractic is actually real and valid? What’s not to trust?”

But then, I was like…


Anklylosing Spondylitis can cause fusion of the vertebrae, up to the entire spine in advanced cases, but that’s the only medical condition that does that. The fusion is a result of chronic arthritic inflammation. This is an autoimmune disorder and posture has nothing to do with it - though AS itself can cause posture and chest expansion problems. I’ve got a degree of incomplete fusion in my neck from the condition, but it’s not particularly bothersome or painful unless I’m in a flare…which hasn’t happened much since I started Simponi, thank goodness.

I’d still like to see any documentation of these changes (i.e. MRIs), as well as a good study(ies) showing that any form of therapy can reverse such changes.

Again, I’m not doubting that aches and pains result from holding an uncomfortable posture for long periods or that various types of manipulation might relieve pain. It’s statements about significant anatomic changes that I’m :dubious: about.

IANAD, but I believe that most bones have muscle on both sides. (or all around, actually). If the muscles on one side are long and flexible, and on the other side are short and non-stretchy, I could see how the bone my start to bow over time. I have no idea if it does, but it makes sense to me. And since everything is connected, I could see how that could cause other problems.

Having said that, last night someone showed me two simple back exercises. This morning I felt an inch taller.

Jackmannii, I know you’re a long-time Doper but I don’t know what your profession is. Are you in the health biz? With all due respect, this concept ain’t rocket science. Study the origins (neck vertabrae) and insertions (clavicle and first ribs) of your scalene muscles, then shorten them. It’s gonna pull the neck out of alignment. Pull far enough and you’ve got a “significant anatomic change”.

I’ve pulled a few links for you. The vast majority of the ones you can find on a simple search point to chiropractic sites. At first I tried to avoid these, then I thought "Fuck it, that’s like saying ‘Teach me about muscles therapy but don’t show me any massage sites’. Spinal alignment is what chiropractors do.

From a massage instructor (cool cadaver pics):

From a massage research site (here’s a study):

From a guy’s blog about his spinal cord tumor (clearly forward head isn’t the main topic, but it’s got the MRI you requested which mentions and shows the physical effects of his forward head posture):

and, finally, (mostly because it had good x-ray pics but also partly because of what I mentioned above) from a chiropractor:



Gold star for tdn. :stuck_out_tongue:

He’s a MD. :slight_smile:

LOL! I’ll only cop to a little bit of egg on my face. In what field? Because I’m genuinely surprised if he doesn’t believe foreshortened muscles can cause anatomical changes.

Really? Awesome!

I’m really starting to get the connection between neck position and lower back pain, though most of my pain is under my shoulder blades.