I've had a few cases recently of pediatric and adult straight neck with persistent neck pain that didn't seem to respond to the traditional neuromusculoskeletal interventions and I thought it would be a good time to bring up a lesser known contributing Problem to chronic postural neck pain.
A loss of cervical normal anterior curvature and a so-called straight neck can be the result of many factors, including flexion trauma, chronic anterior cervical strain associated with use of technology, and some vestibular cerebellar functional disorders. The interventions supporting the chiropractic treatments can be as varied as the causes themselves, including postural awareness and reset, cervical lordotic home device etcetera.
One lesser known contributing factor to chronic anterior cervical malposition is chronic mouth breathing. Normal resting breathing should be through the nose, since this is the most appropriate airway path to warm up air entering the lungs and filter for debris and pathogens. A person will switch from normal nasal breathing to mouth breathing if there is compromise of the nasal airways, in the form of chronic narrow airways ( narrow hard palate in children especially), chronic congestion from allergies or infections, chronic enlarged tonsils and adenoids, and chronic structural issues with the airways such as severe deviated septum. Positioning the head slightly anterior will actually increase the diameter of the oral airway, and becomes an adaptative posture in many patients with upper airway compromise. In patients with strained anterior cervical spine from mouth breathing, the patient will often notice increase neck pain during during cardiovascular endurance activities ( which will further strain the airways and accentuate the adaptative anterior neck posture)as well as during static sitting and laying flat on their back. Mouth breathing is surprisingly common and often completely below a patient's radar unless assessed or noticed by somebody around them.
Obviously resolving chronic cervical discomfort in those patients is going to require looking at resolving some of the underlying airway problems. In the meantime however, in addition to the more traditional chiropractic intervention with manual therapy and corrective exercises, retraining the patient to breathe through their nose with efficiency can make a real big difference in stabilizing the cervical complaints.
