Do you know someone who has a big hump forming in the base of their neck? Perhaps an auntie or grandma? Or perhaps…you?
Previously known as ‘Dowagers Hump’ the term refers to a curving of the spine that can result in your upper back appearing rounded or hunched. The medical term for this type of condition is Kyphosis, and is clinically linked with Forward Head Posture Syndrome, which is where the neck appears craned or poked forward.
Up to 73% of the population may be suffering with Forward Head Posture Syndrome. [1]
This can be unsightly, awkward and can make moving between different positions difficult. But does it have an effect our health?
Forward head posture may be associated with abnormal Autonomic Nervous System function and disturbance of neck sensation and muscular control. [2-5]
A study from 2019 [2] looked at 160 participants, 50% of which had forward head posture and 50% of which had normal head alignment. The authors found that symptoms like aches & pains in the spine may coming from abnormal dysfunction in how the joints in the neck move, and may lead to abnormal nerve messages traveling towards the brain. That is, the feedback into your brain from your upper neck area may become distorted, causing symptoms to worsen.
So apart from noticing that you may be looking awkward in photos, how can you test if you have forward head posture syndrome (FHPS) developing?
A simple method of testing that you can do at home, is to stand against a wall, with your upper back and tailbone/buttocks touching the wall.
If it feels weird or awkward to place your head back to touching the wall, then you may have FHPS developing.
If you can’t place your head back against the wall without your tailbone/buttocks coming off the wall you likely already have FHPS.
Another study [6] revealed the sheer weight of forward head posture and its potential to cause damage in the spine and the possible early onset of spinal arthritis. The numbers were staggering:
In a neutral head position the average human head weighs about 4-5 kg. However, as the head moves forward, this number increases drastically.
At 15 degrees forward, the head weighs 12 kg
At 30 degrees forward, this increases to 18 kg
At 45 degrees forward, this now weighs 22 kg
At 60 degrees forward, this exerts a force of 27 kg on the neck !
In the long run, this is not good news. But as we see now, sustained forward head posture syndrome over several years may have an effect of both effecting the function of the nervous system and triggering early arthritis, not to mention the possible suffering caused by headaches, migraines and pain. [7-9]
Technology and research have come a long way in helping patients suffering with neck pain and headaches, that have Forward Head Posture Syndrome and/or a Dowager’s Hump.
A study in 2018 found that use of specific orthopaedic devices such as Dennerol® (prescribed by a Chiropractor) may significantly reduce or eliminate forward head posture or Dowager’s Hump, and showed to be effective reducing neck pain and increasing neck range of motion (ROM). [10]
Combined use of gentle manipulation with orthopaedic devices like Dennerol® may be significantly helpful in treating neck pain, headaches and upper back pain, and in helping to improve posture. [11-14]
So, great news for our health ...and our photos.
[1] Prevalence of forward head posture and its impact on the activity of daily living among students of Adesh University – A cross-sectional study Sutantar Singh1, Kavita Kaushal1, Smriti Jasrotia1 College of Physiotherapy, Adesh University, Bathinda, Punjab, India
[2] Ibrahim M Moustafa, Ahmed Youssef, Amal Ahbouch, May Tamim, Deed E. Harrison (2020), “Is forward head posture relevant to autonomic nervous system function and cervical sensorimotor control? Cross sectional study, Gait and amp: Posture (2020),
[3] Haavik H, and Murphy B (2011), “Subclinical Neck Pain and the Effects of Cervical Manipulation on Elbow Joint Position Sense,” JMPT Vol 34, Iss 2, Feb 2011, pp. 88-97,
[4] Daligadu J, Haavik H, Yielder P, Baarbe J, and Murphy B (2013), “Alterations in Cortical and Cerebellar Motor Processing in Subclinical Neck Pain Patients Following Spinal Manipulation,” JMPT Vol 36, Iss 8, October 2013 pp. 527-537,
[5] Baarbe J, Holmes M, Murphy H, Haavik H, Murphy B (2016), “Influence of Subclinical Neck Pain on the Ability to Perform a Mental Rotation Task: A 4-week Longitudinal Study with a Healthy Control Group Comparison,” JMPT Vol. 39, Iss. 1, Jan 2016 pp. 23-30,
[6] Staff Writer, (2016), “Stress on the spine: the downside of prolific social media use,” Australian Spinal Research Foundation
[7] Farid B, Yielder P, Holmes M, Haavik H, and Murphy B (2018), “Association of Subclinical Neck Pain With Altered Multisensory Integration at Baseline and 4-Week Follow-up Relative to Asymptomatic Controls,” JMPT Vol. 41 Number 2. Feb 2018, pp. 81-91
[8] Fernandez-de-las-Penas C, Cuadrado ML, Pareja JA. Myofascial trigger points, neck mobility and forward head posture in unilateral migraine. Cephalalgia. 2006; 26(9):1061-70.
[9] Fernandez-de-las-Penas C, Alonsl-Blanco C, Cuadrado ML, Gerwin RD, Pareja JA. Trigger points in the suboccipital muscles and forward head posture in tension-type headache. Headache. 2006;46(3):454-60.
[10] Does improvement towards a normal cervical sagittal configuration aid in the management of cervical myofascial pain syndrome: a 1- year randomized controlled trial Ibrahim M. Moustafa, 1,2 Aliaa A. Diab,2 Fatma Hegazy,1 and Deed E. Harrison3 BMC Musculoskelet Disord. 2018; 19: 396.
[11] Demonstration of Autonomic Nervous Function and Cervical Sensorimotor Control After Cervical Lordosis Rehabilitation: A Randomized Controlled Trial Ibrahim Moustafa, PhD ; Ahmed S.A. Youssef, MSci, Amal Ahbouch, MSci ; Deed Harrison, DCJ Athl Train (2021) 56 (4): 427–436.
[12] Increase in cerebral blood flow indicated by increased cerebral arterial area and pixel intensity on brain magnetic resonance angiogram following correction of cervical lordosis Evan A Katz, Seana B Katz, Curtis A Fedorchuk,1 Douglas F Lightstone,1 Chris J Banach, and Jessica D Podoll2 Brain Circ. 2019 Jan-Mar; 5(1): 19–26.
[13] The effect of normalizing the sagittal cervical configuration on dizziness, neck pain, and cervicocephalic kinesthetic sensibility: a 1-year randomized controlled study Ibrahim M. MOUSTAFA 1, Aliaa A. DIAB 1, Deed E. HARRISON 2 European Journal of Physical and Rehabilitation Medicine 2017 February;53(1):57-71[13] Cerebral metabolic changes in men after chiropractic care (Watanuki and Shibuya, Altern. Ther. Health Med, 2011).
[14] Neurophysiological effects of spinal manipulation, (Pickar, J Spine 2002)