Osteopathy, poor posture & neck pain

News posted by Nikki Harris


Most cases of neck pain have a postural component as part of the underlying problem. Recognising and understanding poor posture can play an important role in finding long-term relief from neck pain.

Good posture is commonly considered to be where the ears are positioned directly above the shoulders, with the chest open and shoulders back.  In this neutral position stress on the neck is minimised because the head’s weight is naturally balanced on the neck (cervical) spine.

Forward head posture occurs when the neck tilts forward, placing the head further in front of the shoulders rather than directly above.


Forward head posture can lead to several problems:

  • Increased stress on the neck (cervical spine): the head is tilted forward in poor posture for prolonged periods. For every inch that the head is held forward in poor posture, an additional 10lbs of weight is felt on the neck spine.  As such, the average head weighs between 10 and 12lbs, just 1 or 2 inches of forward head posture can double or triple the load on the cervical spine.
  • Hyperflexion and hyperextension: the lower cervical spine goes into hyperflexion with the vertebrae tilting too far forward. The upper cervical spine does the opposite and goes into hyperextension as the brain automatically keeps the head up so the eyes can look straight ahead. This alteration of the cervical spine’s curve lengthens the spinal canal distance from the base of the skull to the base of the neck, causing the spinal cord and nearby nerve roots to become somewhat stretched.
  • Muscle overload: some muscles in the neck and upper back must continually overwork to counterbalance the pull of gravity on the forward head. As a result, muscles become more susceptible to painful strains and spasms.
  • Hunched upper back: forward head posture is often accompanied by protracted shoulders and a rounded upper back, which can lead to more pain in the neck, upper back and shoulders.

Workplace posture

The more prolonged the forward head posture (e.g. sedentary jobs in an office or behind the wheel, slouching on the sofa at night, overuse of iPhones and iPads) the more likely that neck pain, stiffness, and other symptoms may develop.

In brief, here are a few recommendations on desk set-up / sitting posture:

  1. When sitting upright at a computer workstation and looking straight ahead, eyes should point directly at the top third of the computer screen.  Use of a monitor or a screen stand is advisable where necessary.
  2. Forearms should be parallel with the floor when typing.
  3. Elbows and knees should be at right angles with the desk and floor.
  4. Feet should be flat on the floor / on a footstool.
  5. Take regular breaks, at least every 30-minutes.

For those who are upright for prolonged periods at work here are a few suggestions on standing posture:

  1. At a standing workstation make sure that one side of the body is not constantly rotated more than the other side. It is beneficial to have as much symmetry as possible in both static and repetitive tasks.
  2. Maintaining the natural curve of the spine when standing promotes good posture.
  3. Keep your head directly over the shoulders.
  4. Keep the shoulders directly over the pelvis.
  5. Engage the deep abdominal (core) muscles.
  6. Tuck in the buttocks.
  7. Place the feet slightly apart, with one foot positioned slightly in front of the other and knees bent just a little bit (not locked).
  8. For prolonged standing on a concrete floor it is best to wear shoes with good support and cushioning.
  9. A rubber mat placed on the concrete floor will ease pressure on the back.
  10. Change position and take regular breaks at least every 30-minutes.


Maintenance treatment with one of our registered osteopaths can help to alleviate neck pain and keep symptoms at bay once under control with a combination of effective and appropriate manual therapy techniques.

Please do not hesitate to contact us to discuss any aspect of your neck pain care or ergonomic set-up: 01525 290615.

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