The Role of Forward Head Posture in Neck Muscle Function Among Women with Chronic Neck Pain

Clinicians in both Pain Management and Primary Care are increasingly recognizing the impact of postural alignment on musculoskeletal health. A growing body of research highlights the association between forward head posture and reduced neck muscle endurance, emphasizing the need for targeted strategies in clinical care.

Among women with chronic neck pain, a study published in the Journal of Electromyography and Kinesiology revealed a direct correlation between forward head posture and both diminished neck muscle endurance and measurable changes in muscle thickness. These biomechanical shifts offer valuable insight into how misalignment can perpetuate discomfort and dysfunction.

Another investigation in the Journal of Bodywork and Movement Therapies found that individuals with forward head posture displayed significantly reduced endurance in cervical flexors and extensors compared to those with neutral head positioning. This reduced capacity underscores the role of posture in the development and persistence of chronic neck pain.

Understanding the interplay between posture and muscle function is essential for accurate diagnosis and tailored treatment. Prolonged postural deviations not only place excessive mechanical strain on the cervical spine, but also appear to lead to disuse atrophy, as suggested by the observed reductions in muscle thickness. These findings are supported by evidence compiled in systematic reviews and clinical practice resources like Physio-Pedia.

One of the most clinically relevant takeaways from these studies is the critical importance of postural assessment. By identifying alignment-related deficits early, clinicians can initiate interventions that target both posture and muscle strength—interventions that are increasingly supported by clinical outcomes data.

Therapeutic strategies such as Global Postural Re-education (GPR) have gained traction due to their efficacy in addressing the structural and functional consequences of forward head posture. A randomized controlled trial published in Physical Therapy demonstrated that GPR significantly improved postural alignment, reduced pain intensity, and enhanced functional mobility in patients with chronic nonspecific neck pain.

These converging lines of evidence make a compelling case for incorporating postural assessment and correction into routine clinical care. By addressing the mechanical and muscular deficits associated with forward head posture, healthcare providers can deliver more precise, effective, and enduring relief for patients suffering from chronic neck pain.