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Straight Neck Syndrome

Straight neck syndrome, also known as military neck, is a condition characterized by the loss of normal cervical lordosis. This is the natural inward curvature of the neck that helps support the head and maintain proper alignment of the spine. This curve is essential for distributing the weight of the head evenly and allowing the neck to absorb shock and stress effectively.

In individuals with straight neck syndrome, the neck appears straight when viewed from the side, instead of having the normal gentle curve.

In this post, we’ll discuss everything about straight neck syndrome.

What Is Straight Neck Syndrome?

The cervical spine is made up of seven vertebrae that are stacked on top of each other, forming the neck region. The normal curvature of the cervical spine helps to distribute the weight of the head and provides stability and flexibility to the neck. 

However, in straight neck syndrome, this curvature is reduced or completely lost, resulting in a straightened appearance. This condition affects the distribution of weight across the neck leading to life-limiting symptoms. 

Symptoms of This Condition

The symptoms of straight-neck syndrome can vary depending on the severity of the condition. Some individuals may experience neck pain, stiffness, headaches, reduced range of motion, and muscle weakness or fatigue. In severe cases, the condition can potentially lead to nerve compression, which may result in radiating pain, tingling, or numbness in the arms or hands.

Head, Neck, Shoulder, And Back Pain

Pain in the neck is a common symptom of straight neck syndrome. The pain can be restricted to the neck or it can radiate to the shoulders, back, or arms.

Cognitive Problems

Cognitive issues are not typically associated with straight neck syndrome itself. However, it’s important to note that chronic pain or discomfort, including neck pain, can indirectly affect cognitive function and mental well-being.

Persistent pain can lead to difficulties with concentration, focus, and memory, as well as fatigue and mood changes. These cognitive issues are more likely to be a consequence of chronic pain and its impact on daily functioning rather than a direct result of the structural changes in the neck.

Spine Deformity

The straightened appearance of the neck may also be accompanied by changes in overall posture. This can include a forward head posture or rounded shoulders.

Stiffness

Individuals with straight neck syndrome may experience stiffness in the neck, which can make it difficult to move the head freely. The reduced flexibility can affect daily activities and range of motion.

Muscle Weakness

The muscles supporting the neck may become weak or fatigued due to the altered posture. This can lead to muscle imbalances and discomfort.

Paralysis

In some cases, straight neck syndrome can cause compression or irritation of nerves in the cervical spine, leading to numbness or tingling sensations that may radiate into the shoulders, arms, or hands. This can further progress to weakness and paralysis. However, this is extremely rare.

Bladder And Bowel Control Issues

The spine is part of a larger interconnected system in the body. Conditions that affect the cervical spine, including straight neck syndrome, can potentially lead to secondary effects on other areas of the body due to nerve impingement or compression. 

If the straightened neck posture causes pressure on the spinal nerves in the cervical region, it is possible to experience referred symptoms in other areas. In rare cases, severe cervical spine conditions or injuries can result in spinal cord compression, which may affect the nerves responsible for bowel and bladder function.

However, it is unlikely to occur with mild to moderate cases of straight neck syndrome.

Common Causes of Straight Neck

Straight neck syndrome can have several common causes. Here are some of them:

Poor Posture

When we have good posture, the cervical lordosis is maintained, and the head is balanced directly over the shoulders. This alignment reduces the strain on the neck muscles and ligaments, promoting a healthy and pain-free neck.

However, poor posture can lead to changes in the neck curve, causing it to flatten or reverse its natural curve. Here’s how different postures can impact the neck curve:

  • Forward head posture: This is a common issue resulting from poor posture, particularly due to prolonged use of computers, smartphones, or other devices. In this position, the head protrudes forward in front of the shoulders, causing the natural curve of the neck to flatten or reverse. 

    The weight of the head is no longer evenly distributed, leading to increased strain on the neck muscles and supporting structures.
  • Slouching or rounded shoulders: When you slouch or have rounded shoulders, it can contribute to a forward head position, which, as mentioned earlier, affects the neck curve.
  • Text neck: This is a specific type of posture related to spending extended periods looking down at a phone or tablet screen. Text neck can cause the neck curve to flatten, as the head is tilted forward for extended periods.
  • Hunchback or kyphosis: Poor posture that involves excessive rounding of the upper back can also impact the neck curve indirectly. Kyphosis can cause compensatory changes in the cervical spine, leading to alterations in the natural neck curve.

Degenerative Disc Disease

As we age, the intervertebral discs in the cervical spine can degenerate or wear down, leading to changes in the spinal alignment. This degeneration can contribute to the development of a straight neck.

Iatrogenic Disorder

Iatrogenic causes of straight neck syndrome refer to situations where the condition is caused by medical interventions or treatments. While iatrogenic causes are relatively uncommon for military neck, there are a few potential scenarios:

  • Cervical Spine Surgery: In some cases, cervical spine surgeries intended to treat other spinal conditions can inadvertently lead to changes in the neck curvature, resulting in a military neck. This can occur if the surgery alters the normal alignment of the cervical spine or if complications arise during the procedure.
  • Radiation Therapy: Radiation treatment for cervical or neck tumors can sometimes cause tissue fibrosis or scarring, leading to changes in the cervical spine curvature and the development of a military neck.
  • Incorrect Neck Immobilization: In certain situations where neck immobilization is required, such as after trauma or during the healing process of fractures or spinal injuries, inappropriate or prolonged immobilization can potentially affect the neck alignment and result in a military neck.

It is important to remember that these iatrogenic causes are relatively rare. The majority of military neck cases are more commonly associated with non-iatrogenic causes, such as poor posture, neck injuries, degenerative conditions, or muscle imbalances.

If you are concerned about iatrogenic causes of military neck, it is best to consult with a healthcare professional who can evaluate your specific situation and provide appropriate guidance based on.

Trauma

Trauma or injuries to the neck, such as whiplash from car accidents, falls, or sports-related incidents, can cause damage to the structures of the cervical spine and lead to a loss of normal cervical curvature.

Congenital Disorder

Congenital conditions are present from birth and can sometimes contribute to the development of a military neck. It’s important to note that congenital conditions causing military neck are relatively rare compared to other causes such as poor posture or degenerative conditions. Here are a few congenital conditions that may be associated with military neck:

  • Klippel-Feil Syndrome: This is a rare congenital disorder where there is fusion or abnormal segmentation of two or more cervical vertebrae. The fusion can restrict neck mobility and lead to a loss of normal cervical curvature.
  • Congenital Muscular Dystrophy: Certain types of congenital muscular dystrophy can affect the muscles responsible for neck support and stability. Muscle weakness or imbalance can contribute to abnormal neck posture, including military neck.
  • Congenital Cervical Spine Abnormalities: Some individuals may be born with abnormalities in the structure or formation of the cervical spine. These abnormalities, such as malformations or abnormalities in the shape or size of the vertebrae, can impact cervical curvature and result in a military neck.

What You Can Do At Home To Help Straight Neck

Preventing military neck or straight neck syndrome involves adopting healthy habits and practices to promote good posture and maintain the natural curvature of the cervical spine. Here are some tips to help prevent military neck:

  • Rest: Rest can be beneficial for military neck, particularly during the acute phase when pain and inflammation are present. Taking a break from activities that aggravate the condition can help reduce strain on the neck and allow the affected tissues to heal. 

    Rest can also provide an opportunity to correct posture and avoid movements that worsen the symptoms.
  • Towel Roll Exercise: The Towel Roll Exercise is a simple and effective exercise that can help improve the curvature of the cervical spine and alleviate the symptoms of the military neck. To perform the Towel Roll Exercise:
    1. Roll up a towel or use a small cushion to create a firm roll.
    2. Sit or stand with your back straight and shoulders relaxed.
    3. Place the towel roll horizontally at the base of your skull, right where the neck meets the head.
    4. Gently press the back of your head into the towel roll without forcefully pushing or straining.
    5. Hold the position for 5-10 seconds while maintaining a comfortable and relaxed breathing pattern.
    6. Relax and repeat the exercise for a total of 5-10 repetitions.
  • Ice or Heat Application: Both heat and ice can be used as part of a comprehensive treatment approach for military neck to help alleviate pain and reduce inflammation. 

    However, the choice between heat or ice depends on the individual’s preferences and the specific stage of the condition. Heat therapy is generally recommended for chronic or subacute stages of military neck when there is no acute inflammation present. 

    Cold therapy, such as ice or cold packs, is beneficial during the acute stage of military neck when there is inflammation and swelling.
  • Mind Your Ergonomics: Ensure that your workstation, including your desk, chair, and computer setup, is ergonomically designed. Position your computer monitor at eye level and maintain a comfortable and supported position while working.
  • Proper Posture: Pay attention to your posture throughout the day, whether sitting, standing, or walking. Keep your head aligned with your shoulders, avoid slouching or hunching forward, and maintain a neutral spine position.
  • Neck Exercises: Engage in regular exercise and strengthening activities that target the neck, upper back, and shoulder muscles. Strong and balanced muscles can help support the cervical spine and maintain proper posture. These include chin tuck exercises and neck and shoulder stretches.

Common Treatment Options for Straight Neck

Treatment for straight neck syndrome aims to address the underlying causes and relieve symptoms.

Physical Therapy

Physical therapy can be an effective treatment approach for military neck or straight neck syndrome. A physical therapist can provide targeted exercises, manual therapy techniques, and education to help improve posture, restore neck curvature, strengthen muscles, and reduce pain and stiffness. Here are some common approaches used in physical therapy for treating military neck:

  • Stretching Exercises: Gentle stretching exercises for the neck, shoulders, and upper back can help improve flexibility, relieve muscle tension, and restore the natural curvature of the cervical spine. These exercises may include chin tucks, neck stretches, and shoulder stretches.
  • Strengthening Exercises: Targeted exercises aim to strengthen the muscles that support the neck and upper back. This helps improve posture, stability, and muscle balance. Examples of exercises may include neck isometrics, scapular stabilization exercises, and exercises for the deep neck flexors.
  • Manual Therapy: Techniques such as manual neck mobilization, soft tissue mobilization, and myofascial release can be used by a physical therapist to address stiffness, muscle imbalances, and joint restrictions in the cervical spine. These hands-on techniques can help improve the range of motion and reduce pain.
  • Pain Management: Physical therapists may employ various modalities, such as heat or cold therapy, electrical stimulation, or ultrasound, to help manage pain and reduce inflammation in the neck region.

Neck Braces

Neck braces, also known as cervical collars or cervical orthoses, may be used in the acute treatment of military neck or straight neck syndrome. They can provide support, and stability, and restrict certain movements of the neck to promote healing and proper alignment. However, long term use of neck braces can have a detrimental effect. 

Long term bracing can cause neck muscle weakness, imbalances, atrophy and lead to more neck instability, pain, loss of range of motion, and chronic problems. Bracing should only be used temporarily a few days or weeks and under a doctor’s supervision.

Here’s how neck braces are typically used:

  • Immobilization And Rest: In some cases, particularly when there is acute neck pain or following an injury, a neck brace may be prescribed to immobilize the neck and provide rest to the affected area. This helps protect the neck from further strain or injury and allows the tissues to heal.
  • Postural Support: Neck braces can assist in maintaining proper posture by providing external support to the neck and upper back. They can help prevent slouching, forward head posture, or excessive bending of the neck, which can contribute to military neck.
  • Pain Reduction: By limiting movement and providing support, neck braces can help reduce pain and discomfort associated with military neck. The brace helps distribute the weight of the head more evenly and may alleviate strain on the neck muscles and structures.
  • Facilitating Healing: Neck braces can help promote the healing process by reducing stress on the neck and allowing damaged tissues to recover. They provide stability to the cervical spine, which may be beneficial for certain injuries or conditions associated with military neck.

Again braces should only be used in the acute phase of a neck injury and not longer than a few days unless otherwise advised by a physician.

Chiropractic

There is a specific type of chiropractic care called chiropractic biophysics (CBP) in which providers focus on helping to restore proper neck and spinal curves. This method has research to support its use to help improve straight neck syndrome.

Mild Medications For Pain Relief

Pain medications may be used to manage the discomfort associated with military neck or straight neck syndrome. The specific choice of pain medication depends on the severity of the pain, individual factors, and the healthcare provider’s judgment. Here are some common pain medications that may be used:

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve) are commonly used to relieve pain and reduce inflammation associated with military neck. They can help alleviate mild to moderate pain. 

However, these medications can have many potential side effects, especially when used for longer than one week. Judicious use of these is advised. 

  • Acetaminophen: Acetaminophen (Tylenol) is an analgesic that can help relieve pain associated with military neck. It is not an anti-inflammatory medication but can be effective for managing mild to moderate pain.
  • Muscle Relaxants: In cases where muscle spasms or muscle tension contribute to the pain, muscle relaxants such as cyclobenzaprine (Flexeril) or methocarbamol (Robaxin) may be prescribed to help relax the muscles and reduce pain. These medications can cause drowsiness and are best used for shorter durations of time rather than chronically. 
  • Prescription-Strength Nsaids: In more severe cases of pain and inflammation, a healthcare provider may prescribe stronger NSAIDs that are available in higher doses or with a longer duration of action.
  • Opioid Analgesics: In rare cases of severe pain that does not respond to other pain medications, opioid analgesics may be prescribed. However, due to the potential for dependence and other side effects, opioids are typically used cautiously and for a limited duration.

Spinal Fusion

Spinal fusion surgery may be considered a treatment option for military neck or straight neck syndrome in certain extreme cases. Spinal fusion aims to stabilize and correct the alignment of the cervical spine by permanently fusing two or more vertebrae. Here’s an overview of how spinal fusion can treat military neck:

  • Stabilization Of The Cervical Spine: By fusing the affected vertebrae, spinal fusion surgery provides stability to the cervical spine. This stabilizing effect can help address the loss of normal cervical curvature and prevent further progression of military neck.
  • Restoration Of Spinal Alignment: The surgery aims to restore the normal alignment of the cervical spine by correcting the straightened or kyphotic curvature. This can potentially alleviate symptoms associated with military necks, such as neck pain, stiffness, and reduced range of motion.
  • Limitation Of Excessive Movement: Spinal fusion restricts excessive movement at the fused spinal segment(s). This limitation can help reduce strain on the affected area, decrease pain, and potentially prevent further degeneration or progression of the condition.

Spinal fusion surgery for military neck is typically considered when a patient is having disk or nerve pain/injuries that conservative treatments, such as physical therapy, pain medications, and postural corrections, have been unsuccessful or when the condition is severe and significantly affects a person’s quality of life. 

The decision to proceed with spinal fusion is made on an individual basis, taking into account factors such as the underlying cause, the severity of symptoms, response to conservative treatments, and the overall health of the patient. It’s important to note that spinal fusion is a major surgical procedure that carries risks and requires a recovery period. 

The decision to undergo spinal fusion should be made in consultation with a spine specialist or orthopedic surgeon who can evaluate your specific situation, thoroughly discuss the potential risks and benefits, and help you make an informed decision based on your unique circumstances. Unless there is urgent nerve injury then surgery should always be a last resort option.

Non-Surgical Injections

Steroids can be injected into neck structures  damaged by straight neck syndrome such as the fact joints or around irritated neck nerves. These may help reduce inflammation and pain for a few weeks to a few months. At best, these can calm down pain enough to better engage in physical therapy and therapeutic exercises that help to correct the straight neck. 

However, steroids often need repeat doses and unfortunately come with many potential negative side effects. These risks include potential bone loss, weakening of surrounding tissues, increasing blood sugars, and alterations of hormones. 

Some studies show that steroids may also reduce the presence of the body’s natural healing factors, such as stem cells. Also, steroids do not address the underlying cause of military neck nor do they help the damaged tissues and in fact can worsen damage over time.

Regenerative injections

When conservative therapies do not help straight neck syndrome enough there are newer regenerative medicine options that help address some of the underlying structural causes of military neck. With these types of procedures, you can avoid the side effects of drugs and steroids and avoid more invasive and risky surgeries. 

The latest advancements in treating conditions that affect tmilitary neck includes  prolotherapy, Platelet-Rich Plasma therapy (PRP), and bone marrow concentrate containing stem cells.

These advanced alternative therapies help regenerate, heal, and strengthen damaged tissues that result from straight neck syndrome. 

The Centeno-Shultz clinic explores all the below advanced medical treatment options for patients who suffer from debilitating, chronic neck disorders.

Prolotherapy

Prolotherapy is a procedure that involves injecting a solution of hypertonic dextrose and anesthetic directly into the damaged ligaments of the neck. This injected solution aims to better stimulate the body’s natural healing response that may have been lacking. Strengthening the neck ligaments can also help with reducing the straightening of the neck.

We have published on the results of improving neck stability with prolotherapy. You can read about it here: Final Fluoroscopically Guided Cervical Prolotherapy.indd (painphysicianjournal.com).

Platelet-Rich Plasma Therapy (PRP)

PRP therapy involves drawing a blood sample, concentrating the platelet component, and reinjecting this concentrated solution into the affected areas of the neck. The concentrated solution of PRP is rich in your body’s natural healing and regenerative factors.

This can be used to treat neck ligaments, muscle tendons, facet joints, irritated nerves, and the intervertebral disks (1).

Bone Marrow Concentrate (Containing Stem Cells)

Bone marrow is rich in cells such as stem cells and others that can facilitate a healing response similar to, but even stronger than PRP. Bone marrow can be comfortable taken from the iliac crest (back hip bone) where the marrow cells are isolated, concentrated, and then injected into the neck’s damaged tissues.

Due to stem cells’ ability to restore damaged tissues, this can aid in healing and recovery for more severe injuries related to straightening of the neck. These cells have been studied to be effective in treating a variety of orthopedic problems (2021 Bone Marrow Research Infographic – Regenexx)

Have Yourself Checked Today

If you are experiencing symptoms or suspect that you may have military neck, seek an evaluation with one of the physicians at the Centeno Schultz Clinic. Our team of board-certified physical medicine and rehabilitation physicians are the best to evaluate and diagnose military neck. 

We will conduct a thorough examination, order any necessary imaging tests, and develop a treatment plan tailored to your specific needs. 

Since all the physicians at the Centeno Schultz clinic are fellowship-trained in interventional orthopedics and regenerative medicine, they specialize in offering non-drug and non-surgical solutions that help address the underlying problems to promote healing with safe, effective, and long lasting results.

Early intervention and appropriate management can help prevent further progression of the condition and promote better neck health.

Get evaluated and free yourself from neck pain!

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

John R. Schultz M.D. is a national expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate for orthopedic injuries. He is board certified in Anesthesiology and Pain Medicine and underwent fellowship training in both. Dr. Schultz has extensive experience with same day as well as culture expanded bone marrow concentrate and sees patients at the CSC Broomfield, Colorado Clinic, as well the Regenexx Clinic in Grand Cayman. Dr. Schultz emphasis is on the evaluation and treatment of thoracic and cervical disc, facet, nerve, and ligament injuries including the non-surgical treatment of Craniocervical instability (CCI). Dr. Schultz trained at George Washington School of…

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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Reference:

  1. Ultrasound-Guided Cervical Intradiscal Injection with Platelet-Rich Plasma with Fluoroscopic Validation for the Treatment of Cervical Discogenic Pain: A Case Presentation and Technical Illustration – PMC (nih.gov), Cureus | Regenerative Injection Treatments Utilizing Platelet Products and Prolotherapy for Cervical Spine Pain: A Functional Spinal Unit ApproachCervical facet joint platelet-rich plasma in people with chronic whiplash-associated disorders: A prospective case series of short-term outcomes – ScienceDirect, https://pubmed.ncbi.nlm.nih.gov/34323453/, https://pubmed.ncbi.nlm.nih.gov/34323453/

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