Forward Head Posture Treatment in Murray, Utah

The head normally sits in a relationship with the shoulders, thoracic spine and cervical spine below it.

With forward head posture, the head is translated farther forward relative to the trunk.

That translation is important to distinguish from another measurement: cervical lordosis, or the curvature of the cervical spine.

A person can have:

• increased anterior head translation;
• an altered cervical curve;
• both findings together;
• or a temporary forward position related to a particular activity.

These are related concepts, but they are not the same measurement.

That's one reason Dr. Woodmansee doesn't evaluate forward head posture from appearance alone.

Forward head posture can be evaluated in different ways depending upon the clinical question.

A postural examination may assess the position of the head relative to the trunk and shoulders. Research studies frequently use photographic measurements such as the craniovertebral angle to quantify forward head posture.

When cervical radiographs are clinically appropriate, additional measurements can evaluate spinal alignment, including anterior head translation and cervical lordosis.

At Comprehensive Chiropractic Clinic, objective measurements allow us to ask better questions:

How far is the head translated?

What does the cervical curve look like?

Are those findings changing over time?

And just as importantly:

Do those measurements matter in the context of this patient's symptoms and examination?

This deserves a more careful answer than simply saying yes.

Forward head posture has been associated with neck pain in some populations, and altered cervical posture may coexist with neck pain, muscle fatigue, headaches and other complaints.

But an association does not mean that forward head posture is the cause of every patient's symptoms.

Neck pain and headaches can have many potential contributors. Numbness, tingling, weakness, severe headaches and other neurological symptoms can also require evaluation for conditions that have little or nothing to do with posture.

That is why we don't diagnose the source of someone's symptoms simply by looking at their posture.

Instead, we ask whether a measured structural finding is clinically relevant to that individual patient.

Phones, computers and other activities can put us in prolonged flexed or forward-head positions.

That doesn't mean everyone who looks down at a phone has developed a structural spinal disorder.

The distinction is between a temporary position and a persistent postural or structural finding that remains present when the person is assessed under standardized conditions.

If you're concerned that your posture has changed, the useful question isn't:

“How many pounds heavier has my head become?”

It's:

“Is there a measurable postural or structural change, and does it matter for me?”

That's something we can evaluate.

A structural evaluation begins with the patient—not the X-ray.

This distinction is central to how we evaluate cervical structure.

Anterior head translation describes how far forward the head is positioned.

Cervical lordosis describes the sagittal curvature of the cervical spine.

One can change without the other changing by the same amount.

That means simply “getting the head back” isn't necessarily the same thing as changing cervical curvature.

When radiographic measurements are clinically appropriate, Dr. Woodmansee can evaluate these structural variables separately and compare them over time.

Dr. Woodmansee holds Advanced Certification in Chiropractic BioPhysics® (CBP).

CBP is a structural rehabilitation approach that uses objective postural and spinal measurements to help determine individualized corrective strategies.

Depending upon the patient's findings and tolerance, a corrective program may include:

Yes—measured posture and cervical alignment can change in selected patients.

The more important question is how much change occurs, under what treatment protocol, in which patients, and whether the change is maintained.

A 2003 nonrandomized controlled clinical trial by Harrison and colleagues evaluated a CBP cervical extension-compression traction protocol combined with cervical manipulation. The treatment group demonstrated measurable radiographic changes, including a mean 11 mm reduction in anterior head weight-bearing and changes in cervical lordosis. Twenty-one treated participants underwent additional follow-up averaging 14 months, with the reported alignment improvements maintained in that subset.

A 2023 randomized controlled study examined 66 older adults with chronic nonspecific neck pain and forward head posture. Both groups received rehabilitation; the CBP group received mirror-image exercise and a Denneroll cervical traction orthotic, while the comparison group performed standardized stretching and strengthening. The CBP group demonstrated improvement in the study's forward-head-posture measurement, with differences between groups also present at three-month follow-up.

These studies don't mean every patient will achieve the same structural change.

They demonstrate something more useful: posture and cervical alignment are measurable outcomes that can change under specific rehabilitation protocols in selected study populations.

Structural rehabilitation should give us something more objective than:

“It looks better.”

When appropriate, Dr. Woodmansee compares the measurements used at the beginning of care with follow-up findings.

That may include changes in:

• anterior head translation;
• cervical lordosis;
• postural alignment;
• symptoms and functional limitations;
• movement or examination findings.

Structural improvement and symptom improvement are related questions, but they are not automatically the same outcome.

A patient may feel better without achieving a particular structural target. Conversely, a measurable structural change does not prove that every symptom was caused by the original alignment.

That distinction is important when evaluating results.

Cervical & Thoracic Structural Correction — Individual Case

In this individual case, cervical radiographic measurements were obtained before and after a seven-week rehabilitation period.

The patient's program included mirror-image postural adjustments, cervical and thoracic extension traction, and in-clinic and home postural rehabilitation exercises.

These measurements show what changed in this individual patient. They do not predict how another patient will respond, and they do not by themselves establish that a particular symptom was caused—or resolved—by the measured alignment.

Forward head posture is easy to see.

Understanding what it means is harder.

Dr. Dirk Woodmansee has been in clinical practice since 1997 and holds Advanced Certification in Chiropractic BioPhysics®.

At Comprehensive Chiropractic Clinic, structural findings aren't considered in isolation. Dr. Woodmansee looks at the patient's history, symptoms, neurological and clinical examination, posture, spinal alignment and imaging when appropriate.

When structural rehabilitation is indicated, we can establish measurable findings at the beginning of care and reassess them rather than relying only on appearance.

The goal isn't to promise a “perfect posture.”

It's to determine whether there is a meaningful structural problem, whether it is appropriate to address it, and whether the measurements actually change.

About Dr. Dirk Woodmansee

1. Harrison DE, Harrison DD, Betz JJ, et al. Increasing the cervical lordosis with chiropractic biophysics seated combined extension-compression and transverse load cervical traction with cervical manipulation: nonrandomized clinical control trial. Journal of Manipulative and Physiological Therapeutics. 2003;26(3):139–151.

   The trial reported measurable changes in cervical alignment and anterior head weight-bearing following the studied treatment protocol. Because the trial was nonrandomized and used a specific intervention and selected population, its findings should not be generalized to every patient.

2. Al Suwaidi AS, Moustafa IM, Kim M, Oakley PA, Harrison DE. A Comparison of Two Forward Head Posture Corrective Approaches in Elderly with Chronic Non-Specific Neck Pain: A Randomized Controlled Study. Journal of Clinical Medicine. 2023;12(2):542.

   This randomized trial involved 66 older adults with chronic nonspecific neck pain and forward head posture and compared two rehabilitation approaches over six weeks with three-month follow-up. The population and protocol matter when interpreting the results.

3. Oakley PA, Ehsani NN, Moustafa IM, Harrison DE. Restoring cervical lordosis by cervical extension traction methods in the treatment of cervical spine disorders: a systematic review of controlled trials. Journal of Physical Therapy Science. 2021;33(10):784–794.

   The review identified nine controlled trials meeting its criteria. Across those studies, cervical extension-traction protocols were associated with increases in radiographically measured cervical lordosis in selected populations. The included studies varied in protocol and population.

Some authors in the cited CBP literature report professional or commercial relationships with Chiropractic BioPhysics organizations or related rehabilitation methods. Study design, population and disclosed conflicts are important considerations when interpreting the evidence.