Reversal of Cervical Lordosis and Cervical Kyphosis Charlotte NC | Neck Curve | Clear Life Scoliosis

By Dr. Justin M. Dick, DC · Clear Life Scoliosis and Chiropractic Center, Charlotte, NC · Published November 01, 2026

A reversed cervical lordosis, also called cervical kyphosis, means the neck curves backward instead of forward on a side-view radiograph. "Straightening" or "loss of lordosis" means the curve is reduced. Whether this causes neck pain is disputed. McAviney and colleagues measured 277 neck radiographs and found patients with neck complaints were more likely to have lordosis of 20° or less, and 18 times more likely to have 0° or less. Grob and colleagues studied 107 adults over 45 and found no difference in neck curvature between those with and without neck pain. Both studies are cross-sectional, and the disagreement is real.

I am Dr. Justin M. Dick, DC, at Clear Life Scoliosis and Chiropractic Center in Charlotte, NC. I am Chiropractic BioPhysics certified and hold CNMT and ARRT(N)(CT) imaging credentials. I have published on abnormal neck mechanics in scoliosis patients and on a post-collision case with neurological deficits, so this topic is close to my own research.

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What the Terms on Your Report Mean

Lordosis is the normal forward curve of the neck. Hypolordosis or straightening means less curve. Kyphosis or reversal means the curve bends the other way, either across the whole neck or at one segment. Grob and colleagues found a segmental kyphosis of more than 4° at one level in 23 percent of people with neck pain and 17 percent without, most often at C4-C5.

Why the Evidence Conflicts

McAviney and colleagues, a group affiliated with CBP NonProfit, found a significant association between cervical pain and lordosis under 20° and proposed 31° to 40° as a clinically normal range. Grob and colleagues, at a Swiss surgical spine unit, found no association between global or segmental curvature and pain, duration, radiating symptoms, or disability, and concluded the structural changes were coincidental. The populations differed: McAviney studied a broad age range of chiropractic radiographs, while Grob studied volunteers over 45 being treated for lower limb problems. Neither design can show cause. My reading is that a reversed curve is not proof of a pain source, and a normal curve does not rule out a structural problem.

Neck Alignment in Scoliosis

Scoliosis does not stop at the thoracic spine. My retrospective cross-sectional study of cervical mechanics in scoliosis patients analyzed neck alignment in this group, and our cervical alignment page covers why the neck is included in every scoliosis evaluation at our office.

What Treatment Has Measured

Harrison and colleagues ran a nonrandomized controlled trial of 30 patients with cervicogenic pain and reduced lordosis against 24 controls. Spinal manipulation plus a 3-point bending cervical extension traction for about 9 weeks reduced pain from 4.3 to 1.6 on a 10-point scale and improved the C2-C7 curve by 14.2°, with only 3.5° lost at 15.5 months. Controls did not change. This trial was not randomized and the authors developed the method, which limits it. It shows the curve can change; it does not establish that curve change caused the pain change.

After a Car Accident

A reversed curve seen after a collision may be new, may be muscle guarding, or may have been present before. Comparing with prior films and checking for abnormal motion on flexion and extension views helps separate these. My post-collision cervical case report documents a 28-year-old woman with pre-existing scoliosis whose reduced lordosis and abnormal segmental motion were accompanied by C5 to C8 weakness; after 17 visits her neurological findings normalized and repeat films showed increased lordosis.

How Dr. Justin M. Dick, DC Evaluates the Cervical Curve at Clear Life

At our Charlotte office, cervical alignment is measured on a neutral lateral radiograph when clinically indicated, with flexion and extension views when instability is suspected, and correlated with a neurological exam. Care can include structural rehabilitation and traction, with repeat measurement. Neurological red flags are referred.

Comparison

Research and Evidence

Evidence tiering: McAviney and Grob are cross-sectional studies with opposite conclusions; Harrison is a nonrandomized controlled trial by the method's developers; my cases are single-patient reports. No randomized trial has shown that restoring cervical lordosis reduces pain compared with treatment that does not target the curve. I state these limitations because they are real.

My own published work: A Retrospective Cross-Sectional Analysis of Abnormal Cervical Mechanics in Patients With Scoliosis (Cureus, 2025, PMID 41018459) and Radiographic Sagittal Alignment and Neurological Changes Following Conservative Cervical Structural Rehabilitation After Motor Vehicle Collision in a Patient With Pre-existing Scoliosis: A Case Report (Cureus, 2026, PMID 41783554). The second is a single case, and causation cannot be established from it.

References

1. McAviney J, Schulz D, Bock R, Harrison DE, Holland B. Determining the relationship between cervical lordosis and neck complaints. J Manipulative Physiol Ther. 2005;28(3):187-93. doi:10.1016/j.jmpt.2005.02.015
2. Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J. 2007;16(5):669-78. doi:10.1007/s00586-006-0254-1
3. Harrison DE, Cailliet R, Harrison DD, Janik TJ, Holland B. A new 3-point bending traction method for restoring cervical lordosis and cervical manipulation: a nonrandomized clinical controlled trial. Arch Phys Med Rehabil. 2002;83(4):447-53. doi:10.1053/apmr.2002.30916
4. Dick JM. A retrospective cross-sectional analysis of abnormal cervical mechanics in patients with scoliosis. Cureus. 2025;17(8):e91098. doi:10.7759/cureus.91098
5. Dick JM, Paige P. Radiographic sagittal alignment and neurological changes following conservative cervical structural rehabilitation after motor vehicle collision in a patient with pre-existing scoliosis: a case report. Cureus. 2026;18(3):e104584. doi:10.7759/cureus.104584

Frequently Asked Questions

Service Area

Clear Life Scoliosis and Chiropractic Center sees patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, Fort Mill SC. Families from across the Charlotte region and the South Carolina border communities come to the Rachel Freeman Way office for radiographic scoliosis evaluation with Dr. Justin M. Dick, DC.

Related Pages

• Cervical Alignment in Scoliosis
• Tech Neck
• Neck Pain After a Car Accident
• Cervical Rehabilitation Case Report
• Chiropractic BioPhysics in Charlotte
• Flexion and Extension X-Rays
• Cervical Instability After a Car Accident
• Neck Pain, Headaches, and Dizziness After an Accident
• Cervical Mechanics in Scoliosis Study
• Dr. Justin M. Dick, DC Research

Schedule an Evaluation in Charlotte

If your report says your neck curve is reversed or straightened, the measurement needs context from your exam and history. Dr. Justin M. Dick, DC provides that review at our Charlotte office.

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