Straight Neck Syndrome aka Loss of Cervical Curve

Military Neck

X-ray view of head, neck and thoracic areas.
Cervical kyphosis is a posture problem that sometimes causes neck pain. Science Picture Co./Collection Mix: Subjects/Getty Images

A normal neck has a gentle curve to it, the degree of which can vary according the the position you are in. But when you lose this curve, it may possibly throw your posture off. Several terms are used to describe the family of flat neck syndromes, including "cervical kyphosis," "loss of cervical curve," "flat neck syndrome," "reversed neck curve," and "military neck."

Whatever it's called, the potential for a decrease in the amount of your neck curve deserves some attention.

While not among the most severe of neck maladies, it can affect your well-being.

Spinal Curves - The Abridged Version

Your spine is divided into four curves. When viewed from the side, two curves — often called "normal kyphotic curves," or kyphosis — go backward. These are the curves we're not talking about in this article.

The other two curves sweep forward and are called "normal lordotic curves" or lordosis.

What's the difference between kyphotic and lordotic?

We are born with our kyphotic curves; we develop our lordotic curves as we gain the ability to lift our head and learn to walk. For this reason, kyphotic and lordotic curves are sometimes referred to as primary and secondary (also compensatory) curves, respectively.

All curves, including the lordosis in the neck, help balance the spine and protect it from the compressive effects of gravity. In fact, the curves work together to do this.

Carolyn Kinser and Lynn Colby, both physical therapists, and authors of Therapeutic Exercise: Foundations and Techniques comment that the flexibility contributed by the curves offers 10 times more resistance to this compression due to gravity than does a straight spine.

Straight neck syndrome is a condition in which the normal lordosis of the cervical spine diminishes, or even fully lost.

Cervical kyphosis (aka revered neck curve) is the condition in which the neck curve goes past the point of straight, and reverses direction. 

Characteristics of Flat (and Reversed) Neck Syndrome

A decreased amount of neck curve lordosis is not the only characteristic of flat or reversed neck syndrome. Kinser and Colby also report increased flexion (i.e. forward bending) at the joint between the skull and the first bone (called the atlas) of the neck. 

They add that the excessive bending at this location exaggerates axial extension, which is a stretching or lengthening that can go through the trunk and its structures, especially the spine. This is one way a flat neck may affect other areas of your posture and spinal column.

Amy Matthews, internationally regarded yoga teacher, Body-Mind Centering® practitioner, and author of Yoga Anatomy comments when a yoga or Pilates teacher gives the instruction to "lengthen your spine," the result is usually axial extension.

But Matthews asserts that axial extension is not always ideal for the body, saying "it's not the most efficient use of the musculoskeletal system." 

"Taking curves out of your posture means your posture no is longer neutral," she explains.


"In axial extension, there's less movement available, partly because we have to engage the muscles so strongly to maintain it." 

And, a loss of some or all of your cervical curve makes the muscles at the front of your neck less flexible, according to Kinser and Colby. The two therapists say flat neck syndrome may put too much stretch in neck muscles such as the levator scapula, scalene, and sternocleidomastoid muscles.

They add that flat neck sometimes accompanies another posture problem known as military back or flat upper back.

Causes of Straight Neck and Reversed Cervical Curve

Some of the causes of a straight neck and/or reversed neck curve include:

·        Degenerative disc disease

·        Birth defects

·        Spine surgery (called "iatrogenic injury)

·        Neck injury or trauma

·        Tumors, infection or systemic disease

·        Text neck, which comes from repeated neck flexion while using mobile devices.

Does Flat Neck Syndrome Cause Pain?

While the jury (medical research) is still out as to whether flat neck and reversed cervical curve cause any symptoms, according to Kinser and Colby, they do. They duo offers 3 reasons why flat neck syndrome may cause pain:

  1. Your TMJ joint can become dysfunctional based on a habit of keeping mandible (lower jaw) forward as part of the posture.
  2. Predisposition to injury because you lose the shock absorbing function that a normal neck curve provides.
  3. Stress to a spinal ligament called the ligament nuchae.

And at least one research study (from 2005) has measured the point at which flat neck becomes painful. Researchers looked at 277 neck x-rays and determined that those with smaller curve degrees (i.e., 20 or less) were more likely to have symptoms associated with this syndrome. For reference, a normal neck curve ranges from 31 and 40 degrees.) Their study was published in the Journal of Manipulative Physiological Therapeutics in March 2005.

Treatment for Flat Neck Syndrome

While most of the time, you don't need treatment for a flat neck, many people benefit from chiropractic. Massage, exercise and/or physical therapy may also be helpful. One particular exercise that nearly every health provider who treats this condition gives to their patients is the cervical retraction exercise.

In rare cases - when the spinal cord is disrupted - surgery may be needed. Check with your doctor if you have concerns or questions about your flat neck syndrome and/or cervical kyphosis.


Hey, H., et. al. Cervical Alignment Variations in Different Postures and Predictors of Normal Cervical Kyphosis - A New Understanding. Spine. March 2017.

Kinser, C., Colby, L.A., Therapeutic Exercise: Foundations and Techniques. 4th Edition. F.A. Davis Company. Philadelphia, PA. 2002.

Kyphosis. Last Reviewed June 2015.

McAveny, J. et. al. "Determining the Relationship Between Cervical Lordosis and Neck Complaints" Journal of Manipulative Physiological Therapeutics. March 2005. Accessed July 2015.