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Cervical Hyperlordosis, Forward Head Posture, and Lumbar Kyphosis Correction: A Novel Treatment for Mid-Thoracic Pain

ABSTRACT
Objective: To describe a novel approach to correcting cervical hyperlordosis and forward head posture in the treatment of mid-thoracic pain using specific rehabilitative equipment

Clinical Features: A 27-yr-old male patient had a chief complaint of intense, episodic mid-thoracic pain. A posture examination revealed several abnormalities, including apparent thoracic humping or buckling, along with significantly rounded shoulders. Radiological study resulted in a finding of a 52° cervical lordosis and forward head posture (FHP) validated by 2 separate measurements.

Intervention and Outcome: Treatment included 10 visits in 24 days, consisting of spinal manipulative therapy (SMT) combined with a 4-lb headweight device and a figure-8 clavicle brace, followed by positional traction on an intersegmental traction table. Specific instructions for home care were provided to the patient. Post-trial radiographs showed a reduced cervical lordosis of 40° and a reduction in FHP of 12mm,
according to 1 of the 2 FHP measurements. An incidental improvement was also recorded for the lumbar lordosis. Patient symptoms were alleviated by the end of the trial period.

Conclusion: This comprehensive approach appeared to correct specific posture abnormalities seen on x-ray, and had an apparent positive effect on the patient’s chief complaint. Each procedure in this treatment method needs to be tested separately to determine which procedures had the greatest effect.