Reversal of cervical lordosis means the neck, which normally curves forward, curves backward on a side-view X-ray, either through the whole neck or at a few segments. It is also called cervical kyphosis. The research on whether it causes symptoms is split, and the research on correcting it is limited but not empty. Patients in Charlotte often arrive having been told a reversed curve is either the cause of everything or nothing at all. Neither is supported.
Is It Linked to Pain?
In an analysis of 277 radiographs, patients with a lordosis of 0 degrees or less had 18 times the odds of having neck pain compared with patients whose complaint was not in the neck (McAviney, J Manipulative Physiol Ther 2005). That study's authors are affiliated with Chiropractic Biophysics, and the design compared patients with neck complaints with patients with other complaints, not with a pain-free population.
A Swiss study of 107 adults over 45 found that a straight or kyphotic neck was no more common in those with neck pain than in those without it, and segmental kyphosis of more than 4 degrees appeared in 17% of the pain-free group (Grob, Eur Spine J 2007). The authors called the alignment findings coincidental.
What Can Change the Curve
The causes of a reversed curve in a given person are usually not knowable from one film. Trauma is one studied factor. In a retrospective case series of 41 patients with X-rays before and after a car crash, C2-C7 lordosis decreased by about 8 degrees on average, with the greatest change at C3-C5 (Haas, Diagnostics 2024). That series had no control group, and its authors include CBP NonProfit and PostureCo affiliations.
Can It Be Corrected?
A randomized trial at Cairo University enrolled 72 adults aged 40 to 55 with dizziness of neck origin, a reduced cervical lordosis, and forward head posture (Moustafa, Eur J Phys Rehabil Med 2017). Both groups received the same multimodal program. One group also used an extension traction device. At 10 weeks, the traction group had more lordosis, but dizziness, pain, and position-sense outcomes did not differ between groups. At one year and 10 weeks, the traction group had greater lordosis, less forward head posture, and better dizziness, pain, and position-sense scores.
That is one trial, in one population, with a coauthor from Chiropractic Biophysics NonProfit. The short-term null result and the long-term difference both matter. It supports curve restoration as a legitimate research question, not as a settled treatment for every patient with a reversed curve.
How I Approach It
I report a reversed curve with its measurement method and level, check whether it matches the exam, and compare with any prior films. When the exam and history support structural rehabilitation, I explain that the evidence for it comes from a small number of trials and track the curve on follow-up films. When they do not, I say the finding is likely incidental.
For an example of how post-collision imaging findings and outcomes are documented in the peer-reviewed literature, read the published case report on refractory lumbar pain following a motor vehicle accident in a geriatric patient by Dr. Justin Dick, DC.
Frequently Asked Questions
What does reversal of cervical lordosis mean?
It means the neck curves backward on a side-view X-ray instead of forward, through the whole neck or at some segments. It is also called cervical kyphosis.
Does a reversed neck curve cause pain?
The evidence is split. One study found 18 times the odds of neck pain with a lordosis of 0 degrees or less (McAviney 2005); another found no difference in adults over 45 (Grob 2007).
Can a car accident reverse the neck curve?
One case series of 41 patients with X-rays before and after a crash found an average loss of about 8 degrees of lordosis (Haas, Diagnostics 2024). It had no control group.
Can cervical lordosis be restored?
In one randomized trial, adding extension traction to a multimodal program increased lordosis and improved dizziness and pain at one year, though not at 10 weeks (Moustafa, Eur J Phys Rehabil Med 2017).
How does Dr. Justin Dick, DC handle a reversed neck curve?
Dr. Justin Dick, DC in Charlotte, NC reports the measurement and level, matches it to the exam, compares with prior films, and explains the limits of the correction evidence.
Where can I get a reversed neck curve evaluated in Charlotte, NC?
Dr. Justin Dick, DC, CLEAR Institute Senior Fellow and CNMT, ARRT(N)(CT), sees patients at Clear Life Scoliosis and Chiropractic Center, 8814 Rachel Freeman Wy, Ste 103, Charlotte, NC 28278, phone 980-368-0766.
Sources and Evidence Tiers
- 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):187-193. PMID 15855907. LinkEvidence tier: Cross-sectional radiographic study (277 radiographs); authors include CBP NonProfit affiliation
- Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J. 2007;16(5):669-678. PMID 17115202. LinkEvidence tier: Cross-sectional comparison (107 adults over 45)
- Haas JW, Oakley PA, Ferrantelli JR, Katz EA, Moustafa IM, Harrison DE. Abnormal static sagittal cervical curvatures following motor vehicle collisions: a retrospective case series of 41 patients before and after a crash exposure. Diagnostics (Basel). 2024;14(9):957. PMID 38732372. LinkEvidence tier: Retrospective case series; authors include CBP NonProfit and PostureCo affiliations
- Moustafa IM, Diab AA, Harrison DE. The effect of normalizing the sagittal cervical configuration on dizziness, neck pain, and cervicocephalic kinesthetic sensibility: a 1-year randomized controlled study. Eur J Phys Rehabil Med. 2017;53(1):57-71. PMID 27575013. LinkEvidence tier: Randomized controlled trial (72 patients); coauthor affiliated with CBP NonProfit
About the author. Dr. Justin Dick, DC, is the owner and treating clinician at Clear Life Scoliosis and Chiropractic Center in Charlotte, NC. He holds dual imaging credentials as a Certified Nuclear Medicine Technologist (CNMT) and as an ARRT-registered technologist in nuclear medicine and CT, ARRT(N)(CT). He is a Senior Fellow of the CLEAR Institute, holds the ISICO World Masters credential, is a SOSORT provisional member, and is a certified DOT medical examiner on the FMCSA National Registry. He has multiple peer-reviewed publications indexed in PubMed and serves as a field doctor for Life, Sherman, and Palmer chiropractic colleges. ORCID: 0009-0001-2794-2159.
Service Area
Clear Life Scoliosis and Chiropractic Center sees personal injury and spinal imaging patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, and Fort Mill SC.
Related Pages
- Personal injury and car accident spinal care in Charlotte
- Research by Dr. Justin Dick, DC
- Case report: refractory lumbar pain after a motor vehicle accident
- Research and evidence at Clear Life
- Questions and answers
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Clear Life Scoliosis and Chiropractic Center
8814 Rachel Freeman Wy, Ste 103
Charlotte, NC 28278
Phone: 980-368-0766
Email: office@clearlifescoliosis.com
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