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Posture does not correlate with neck pain, headache in 1100 Australian teens

PainSci » bibliography » Richards et al 2016
Tags: neck, hda, structuralism, head/neck, spine, biomechanical vulnerability

Three articles on PainSci cite Richards 2016: 1. Does Posture Matter?2. The Complete Guide to Chronic Tension Headaches3. The Complete Guide to Neck Pain & Cricks

PainSci notes on Richards 2016:

This paper presents indirect but strong evidence that the “text neck” posture does not cause neck pain and headaches in young people, contrary to all the fear-mongering we’ve heard about this in the last couple years. Reseachers took photos of more than 1100 Australian teenagers’ necks, and surveyed their neck problems with a questionnaire. They found some correlations between neck posture and sex, weight, height, and depression … but not pain.

The finding of no association between cluster membership and neck pain and headaches challenges widely held beliefs about the role of posture in adolescent neck pain.

And some long-term follow-up would be nice, of course. The absence of a correlation with pain in young patients does not mean that it won’t occur in time. However, it’s safe to assume that many of these young people have already been looking at their phones a lot for quite a while, and although young people clearly are not immune to neck pain and headaches, those symptoms were not related to their posture in these 1100 teens. Correlations that are nonexistent in the short term are unlikely to be strong in the long run.

(The relevance of the study to “text neck” is an inference I’ve made — a reasonable one, I hope. There’s been an epidemic of fear-mongering about that posture, 2014–2016, and I suspect this is what the authors were referring to with that phrase “widely held beliefs about the role of posture in adolescent neck pain.” Even if the study wasn’t intended to address that over-hyped topic directly, it certainly does the job: the behaviour is so prevalent in young people today that to study teen posture is to study text neck. Whatever sitting postures these kids exhibit, intensive mobile device usage will have been an influence, if it has any affect at all. Ideally, of course, we would like to track healthy kids and see what happens over months and years, observing both their mobile phone usage and static postures. But this study is a good start.)

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: There is conflicting evidence on the association between sagittal neck posture and neck pain. Objective The object of this study was to determine the existence of clusters of neck posture in a 17-year-old cohort and establish whether identified subgroups were associated with biopsychosocial factors and neck pain.

DESIGN: Cross-sectional study.

METHODS:: 1108 adolescents underwent 2D photographic postural assessment in sitting. One distance and four angular measures of the head, neck and thorax were calculated from photo-reflective markers placed on bony landmarks. Subgroups of sagittal sitting neck posture were determined by cluster analysis. Height and weight were measured and lifestyle, and psychological factors, as well as neck pain and headache were assessed by questionnaire. The associations between posture subgroups, neck pain and other factors were evaluated using logistic regression.

RESULTS: Four distinct clusters of sitting neck posture were identified and termed upright, intermediate, slumped thorax/forward head and erect thorax/forward head. Significant associations between cluster and sex, weight and height, were found. Those classified as having slumped thorax forward/head posture were at higher odds of mild, moderate or severe depression. Those classified as upright posture exercised more frequently. There was no significant difference in the odds of neck pain or headache across the clusters.

LIMITATIONS: The results are specific to 17 year olds, and may not be applicable to adults.

CONCLUSION: Meaningful sagittal sitting neck posture clusters were identified in 17-year-olds that demonstrated some differences with biopsychosocial profiling. The finding of no association between cluster membership and neck pain and headaches challenges widely held beliefs about the role of posture in adolescent neck pain.

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