What Causes Straightening of the Cervical Lordosis?

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The fact that the neck has a normal curve is an important and often overlooked issue. In many patients with neck pain, this curve goes away, leading to biomechanical problems that can cause degenerated discs. Now a new study shows that it can also cause decreased blood flow to the back of the brain.

What Is Straightening of the Cervical Lordosis?

If you read a handful of neck X-ray reports, you’ll likely see that the radiologist has said on a few that there is “straightening of the normal cervical lordosis.” To understand what this is, you have to understand how the spine is constructed.

When the normal curve is lost, there are a number of terms used by the radiologist:

  • Straightening of the normal cervical lordosis
  • Loss of cervical lordosis
  • Straightening of the cervical lordosis

Your neck, upper back, and low back all have counterbalanced curves. One goes one way, and the adjoining curve goes the opposite way. When the curve points toward the front, it’s called a lordosis and toward the back, it’s called a kyphosis. These curves balance the force of the head and allow you to stand with minimal muscle energy. They also equally distribute the forces between the front of the individual vertebrae, where the disc is located, and the back of the verterbrae, where the facet joints live.

Illustration of a normal spine, lordosis and kyphosis


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Why Is Straightening of the Cervical Lordosis a Problem?

When you lose the normal neck curve, the weight of the head is no longer balanced by the opposing curve (kyphosis) in the upper back. This causes muscle power to be needed to keep the head upright.

For example, in the picture to the right, the head is being held up by the muscles at the back of the neck, leading to overload where those muscles attach to the skull, causing headache pain. This also causes more weight to be transferred to the discs between the vertebrae, which can lead to more wear-and-tear disc degeneration.

How Does Straightening of the Cervical Lordosis Happen?

One of the more common causes of straightening of the normal cervical lordosis is car crashes where the neck ligaments are damaged. Other causes are more insidious, like looking down all the time to interact with a cell phone, tightness in the chest wall and psoas from sitting too much, or just getting older.

New Research on Straightening of the Cervical Lordosis

While we’ve known that straightening of the neck curve was bad news, a new study just upped the ante of bad stuff that happens when you have this problem (1). This research looked at 30 patients with and 30 matched controls without loss of cervical lordosis. Doppler ultrasound was used to measure the blood flow through the vertebral artery.

This important blood vessel courses through holes in the neck bones, so it could be vulnerable if the relationships between the neck bones change. In the patients with loss of the normal neck curve, the diameter of the artery was small with less and slowed blood flow through the vessel. Yikes! Given that this is one of the major sources of blood flow to the brain, this could be a huge future problem for teenagers who have been glued to their phone since childhood.

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How Can You Treat Straightening of the Cervical Lordosis?

From a conservative-therapy standpoint, there are some nice programs specifically designed to get the curve back. One is used by chiropractors and uses special traction machines to fix the curve. Physical therapists can also work on stretching out and releasing the tight muscles in the chest and pelvis. If the neck ligaments are damaged, then highly precise injections into these ligaments using platelets may help. Surgery is usually not recommended as a viable solution.
The upshot? We’ve known that the neck curve is a big deal in helping avoid structural overload and degeneration of muscles, tendons, and discs, but this new study is a bit scary. The fact that the blood supply to the brain is also impacted by this change is a big concern!

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(1) Bulut MD, Alpayci M, Şenköy E, et al. Decreased Vertebral Artery Hemodynamics in Patients with Loss of Cervical Lordosis. Med Sci Monit. 2016;22:495-500. Published 2016 Feb 15. doi:10.12659/msm.897500

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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