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Cervical curve restoration and forward head posture reduction for the treatment of mechanical thoracic pain using the Pettibon corrective and rehabilitative procedures

Objective: To demonstrate the benefits of reducing forward head posture and restoring the cervical lordosis as a novel approach to treating a patient with mechanical thoracic pain.

Clinical Features: The patient had thoracolumbar junction pain bilaterally that failed to respond to previous sessions of spinal manipulative therapy. Treatment included both manipulative and rehabilitative procedures designed to correct the forward head posture and cervical kyphosis. Treatment progress was quantified on pre and post lateral cervical radiographs.

Intervention and Outcome: The treatment plan was 30 sessions over an 8-week period that included spinal manipulative therapy, used in concert with a new headweight device applied immediately after the manipulation was performed at each session. The patient was also instructed on the performance of certain rehabilitative procedures to be performed in the home setting. The patient experienced significant symptomatic relief
after the 3rd week of care. The cervical lordosis was restored by 144% and the forward head posture was decreased by 56% at the end of the trial period.

Conclusion: Restoration of the cervical curve and reduction of forward head posture appears to have beneficial effects beyond the cervical spine. The addition of active rehabilitative procedures seems to enhance the effectiveness of spinal manipulative therapy in the correction of forward head posture and cervical kyphosis.