The relationship of Posture to TMD, Neck Pain and Headaches


The forward head posture can lead to a multitude of problems which include chronic headaches, migraine, neck and upper back pain, arm and hand pain, tingling numbness of the upper extremities, temporomandibular joint pain or dysfunction (TMJ or TMD), and early degenerative joint disease (DJD) of the cervical spine. When any of the above maladies appear in conjunction with the forward head posture, they have been caused by that posture.

What is a forward head posture? Looking from the side, you visualize a straight line from the middle of the ear, down thru the shoulder and hip to just in front of the ankle. This is proper alignment of the head over the shoulders. But when the ear falls in front of this line you are looking at forward head posture. This posture may occur in early childhood, or during the teenage years, or it may develop from working improperly at a computer. Early detection can prevent many problems.



Some simple physics can be used here to determine the extra stress being placed on the neck and upper back with this head posture. For every one inch that the ear canal lies in front of that imaginary line, you can add 10 pounds to the weight of the head being exerted on the muscles of the neck and upper back. So, if your head weighs 10 pounds, one inch forward would mean your muscles are now carrying around 20 pounds of weight, 2” forward and there is 30 pounds being exerted on those muscles. It is not unusual for me to see a patient with a 3” head forward posture. That means the neck muscles are supporting 40 pounds of weight rather than just balancing 10 pounds above the shoulders.

This constant overexertion on these muscles results in constant strain and chronic pain, and any or all of the above mentioned maladies. The posture causes weakness in the over stretched and over worked muscles, and shortening and weakening of the muscles of the font of the neck. The forward head posture puts the head into extension in relation to the neck, and the upper cervical muscles develop chronic hypertonicity (tightness) and trigger points (tender knots) leading to chronic headaches and possibly migraine. The shortened muscles in the front of the neck, the scalene muscles, exert extra pressure on the first rib and pull it up into the collar bone, pinching nerves that go into the arm. This results in arm or hand pain, or a numb feeling in the hands or arms. This often happens at night and the person wakes in the middle of the night with a hand that has “fallen to sleep”.

The most serious problem is that the extended position of the head exerts additional pressure on the muscles of the jaw. The muscles of the jaw can be strained like the muscles of the back of the neck and become painful. Also the position causes the jaw joint, or temporomandibular joint (TMJ), to work in a narrowed position that will eventually wear it out causing a TMJ problem known as TMD. The continual strain on the muscles of the neck can also lead to a problem known as Eagle Syndrome (chronic pain in the muscles in the side of the neck just under the ear, with calcification of tendon to bone attachment at the styloid process).

What can you do? If you have any of the problems I have discussed in the article and you have a head forward posture, you need to work with a knowledgeable doctor of chiropractic to have your problem properly diagnosed and properly treated. If you have developed TMD you will need to work with a dentist that is a TMJ specialist.

In our clinic I work in conjunction with yoga therapist, Luna Jordan, E.R.Y.T.-500, L.M.T., to both relieve pain and teach the patient a stretching and exercising routine that retrains muscles to correct the head forward posture. When jaw pain is present, our patients will also consult with a TMJ specialist. It is important that the head forward posture be identified early. It is much easier to correct this posture in the teenager before all the other problems associated with it begin to manifest. Prevention is always the best choice. However, we have treated all age groups, the most prominent being the age group working at a computer. So, even if you have had problems for years, don’t give up, treatment is available. See our other article about the proper ergonomics of sitting at a computer.

We are available for phone consultations, please give us a call and get started on your road to recovery.

Michael Crawford, D.C., D.A.P.M. Luna Jordan, E.R.Y.T.-500, L.M.T.

(505) 983-3037 (505) 474-6418

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