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EOS® radiographs demonstrating degenerative spondylosis of the lower cervical spine with osteophytes at posterior C5 and C6, C7/T1 disc-space narrowing, straightened cervical lordosis and thoracic hyperkyphosis, and cystic change of the right humeral head (red arrow). In general, the average angle of thoracic kyphosis and lumbar lordosis is 43.55° ± 6.44 and 32.42° ± 6.29, respectively. CSVL: central sacral vertical line (red line).
Source publication
Upper cross syndrome (UCS) is a condition caused from prolonged poor posture manifesting as thoracic hyperkyphosis with forward head and shoulder postures. It has been associated with several other secondary conditions, causing pain and discomfort to those with the condition. This is a case report of a 35-year-old female presenting to clinic with a...
Citations
... The presence of opposing muscle imbalances in UCS precipitates malalignments in the upper limbs and dysfunction in the atlantooccipital, cervicothoracic, and glenohumeral joints, subsequently contributing to postural irregularities [2]. Additionally, these muscular imbalances give rise to a spectrum of physical symptoms, including but not limited to headaches, neck discomfort, chest pain, upper back pain, tingling sensations in the upper arms, and constraints in the range of motion in the neck or shoulders [3,4]. ...
... Since there is an association between these different conditions with respect to thoracic kyphosis, this association shows that UCS is related to thoracic kyphosis. When an individual experiences UCS for an extended period, it can lead to hyperkyphosis, which is a severe curvature of the spine, leading to heartburn [8]. ...
A sedentary lifestyle has caused adults to spend more than 6 h seated, which has led to inactivity and spinal issues. This context underscores the growing sedentary behavior, exemplified by extended sitting hours among adults and university students. Such inactivity triggers various health problems and spinal disorders, notably Upper Crossed Syndrome (UCS) and its association with thoracic kyphosis, which can cause severe spinal curvature and related complications. Traditional detection involves clinical assessments and corrective exercises; however, this work proposes a multi-layered system for a back brace to detect, monitor, and potentially prevent the main signs of UCS. Building and using a framework that detects and monitors signs of UCS has facilitated patient-doctor interaction, automated the detection process for improved patient-physician coordination, and helped improve patients' spines over time. The smart wearable brace includes inertial measurement unit (IMU) sensors targeting hunched-back postures. The IMU sensors capture postural readings, which are then used for classification. Multiple classifiers were used where the long short-term memory (LSTM) model had the highest accuracy of 99.3%. Using the classifier helped detect and monitor UCS over time. Integrating the wearable device with a mobile interface enables real-time data visualization and immediate feedback for users to correct and mitigate UCS-related issues.
... Opposite-group muscle imbalances in UCS bring postural disturbances, misalignments in the upper limbs, and atlanto-occipital, cervicothoracic, and glenohumeral joint dysfunction [2]. The muscular imbalances may also lead to various musculoskeletal symptoms, such as headaches, neck pain, chest pain, upper back pain, tingling in the upper arms, or a limited range of motion in the neck or shoulders [3,4]. ...
Background and objectives:
Upper crossed syndrome (UCS) is a common musculoskeletal condition that is characterized by tightness and weakness of the muscles of the neck, shoulders, and upper back. The aim of this current study is to summarize and provide an overview of the treatment in patients with UCS.
Materials and methods:
A MEDLINE (PubMed), Cochrane library, Embase, Scopus, and Web of Science database search was conducted for English-language articles about upper crossed syndrome that were published until 19 January 2023. To identify potentially relevant articles, the following key search phrases were combined: "upper crossed syndrome", "upper cross syndrome", "diagnosis", and "treatment". A total of 233 articles were identified. After reading the titles and abstracts and assessing their eligibility based on the full-text articles, 11 articles were finally included in this review. The risk of bias (RoB) was assessed using RoB-2 and ROBINS-I for the randomized controlled trials (RCTs) and the non-randomized clinical trial (non-RCT), respectively.
Results:
Among eleven studies that investigated the effect of treatment programs for UCS, five studies compared the therapeutic effect of exercise programs with controls, whereas six compared different rehabilitative treatment strategies, such as the muscle energy technique, soft-tissue mobilization, and stretching exercises. In addition, regarding the study design, ten studies were RCTs and only one study was a prospective observational study.
Conclusions:
Treatment programs including various types of exercises and techniques to correct an abnormal posture and restore neuromuscular imbalances are effective for decreasing pain and improving neck disabilities and postural deviations in patients with UCS.
... Usually, UCS shows asymmetrical muscle strength of weak and strong muscles, decreased muscle strength of deep cervical flexors, lower trapezius, and anterior serratus; 5 excessive tension of upper trapezius, scapular lift, and pectoralis major; crossover of tight and weak muscle chains, and imbalance of muscle chains, resulting in abnormal posture [21] ( Figure 1). If left untreated, these symptoms greatly impact a patient's quality of life and worsen the progression of cervical spondylosis [22] . ...
Cervical spondylosis is a widespread medical condition that significantly impacts patients' quality of life. Treatment options include surgical and conservative approaches, with conservative treatment often being the preferred choice. Rehabilitation therapy is an essential component of conservative treatment, and advancements in technology have the way to the development of new physiotherapy techniques. The effectiveness of treatment largely hinges on the patient's ability to improve their dysfunction. This study aims to provide valuable insights into the use of new physical therapy techniques, such as Sling Exercises Training (SET), fascia manipulation, muscle energy technique (MET), and proprioceptive neuromuscular facilitation (PNF), that aid the rehabilitation of cervical spondylosis. By scrutinizing the current research status of these techniques, this study aims to present innovative ideas enhancing the rehabilitation process and outcomes for patients suffering from cervical spondylosis.
... Chiropractors believe that the body as a whole is connected, and that the body can sustain its health if the body's integrity is preserved. There are also suggestions that chiropractic could help with a variety of nonmusculoskeletal symptoms such as visual disturbance [43,44], angina and cardiovascular symptoms [45][46][47][48], dysphagia and gastrointestinal disorders [49][50][51][52], and testicular pain and reproductive dysfunctions [53][54][55]. ...
The study is to describe the current evidence for the effectiveness of chiropractic spinal manipulation in comparison to the conservative intervention on Low Back Pain (LBP). The PubMed database was searched for randomised clinical trials of spinal manipulation and low back pain. Criteria for inclusion was subjects with low back pain treated with chiropractic spinal manipulation. Studies were excluded when participants
were under the age of 18; conditions that were considered to be outside the discipline of manual therapy including systemic disease or malignancy, osteoporosis, pathological causes of LBP, LBP with radiculopathy; and contraindications to spinal manipulation. Data extraction included study design, number of participants, gestational age, spinal region, number of manipulations, manipulation technique details, profession of manipulator, active exercise reporting (Yes vs. No), type, and number of active exercises. Chiropractic care seems to be more effective than conservative intervention for LBP in reducing pain, increasing range of motion in lumbar spine, improving disability status, and enhancing general health. Furthermore, integrative care for LBP could be considered to improvise in the future
treatment plan. The review of comparing different treatment approaches for LBP is still lacking and future research is needed to consider including a control group in order to provide accurate and persuasive outcomes.
... As a result, dentists are more prone to developing problems and upper cross syndrome. According to a text review of musculoskeletal problems among dental professionals, the incidence rate of general musculoskeletal pain among dentists stretches between 64% to 93%, with the most widely stated location of pain being the back with 36.3% to 60.1% and the neck being 19.8% to 85% [5]. ...
... Chu and Butler in 2021 presented a case that described the consequences of poor postural positions for a prolonged period on gastroesophageal reflux disease (GERD) [19]. The physiological effect of the upper cross syndrome is that patients can experience heartburn due to acid reflux caused by prolonged and extended sitting periods. ...
Background:
In today's world, the upper cross syndrome is growing more common and becoming very prevalent among dental undergraduate practitioners. One of the most important conditions for which dentists seek physiotherapy treatment is neck pain. It is characterized by overactive pectoralis and trapezius muscles. It is frequently linked to poor posture in dental students' daily life, causing them to miss their work.
Objectives:
The first objective of our study was to find the efficacy of myofascial rollers and post-isometric relaxation technique along with conventional therapy for pain relief and correction of postural deviation in undergraduate dental students. And, the second objective of the study was to compare the effect of myofascial rollers and post-isometric relaxation techniques in upper cross syndrome.
Methods:
The study was conducted with pre-test and post-test methods. The study consisted of 80 participants who were included based on our inclusion and exclusion criteria. The study sample was randomly assigned into two groups. Each group consisted of a total of 40 participants. Group A was treated using myofascial rollers and hot packs, and Group B was treated using the post-isometric relaxation technique and hot packs. Patients were asked to mark their intensity of pain on the Numerical Pain Rating Scale and an assessment of postural deviations (in mm) was noted through a plumb line in the posture grid. Posture assessment was done in lateral view. The protocol covered four weeks of treatment based on the defined protocol. Finally, the t-square test and Chi-square test were used to compare the difference in the result. Also, the level of significance was kept at <0.05.
Result:
Statistical analysis was done using descriptive and inferential statistics using student paired, unpaired, and chi-square test. IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States) was used. The Numerical Pain Rating Scale showed mean deviations of (4.15±1.29) for Group A and (3.30±1.01) for Group B. Plumb line assessment showed mean deviations of (9.09±4.31) for Group A and (6.33±2.36) for Group B. Also, Numerical Pain Rating Scale showed (t=3.26, p=0.002) and Plumb line deviation showed (t=3.57, p=0.001).
Conclusion:
Through our study, we conclude that statistically no significant differences were found in pre-intervention and post-intervention, but myofascial rollers gave better results as compared to the post-isometric relaxation technique in alleviating pain and correcting postural deviation.
... Simple stretching method includes different stretches among which passive stretches also included. With the help and aid of an assistant, machine, therapist weight or pulley system one can uses forces externally to stretch the desired body tissue 12 . An advance type of stretching technique used to treat tight muscles is muscle energy technique. ...
Aim: To compare the effects of stretching exercises & muscle energy techniques in the management of lower cross syndrome. Methods: In this parallel, randomized controlled trail fifty-eight patients were randomly assigned into two intervention groups. Group A received stretching technique and Group B received muscle energy technique, three sessions per week for total duration of four weeks. Results: Normality test applied and P values were noted by applying Shapiro-Wilk test both groups. Baseline measures for both groups showed no significant difference as the P value > 0.05. The paired t-test within the group of Stretching and Muscle Energy Technique showed significant difference in pre and post Numeric Pain Rating Scale (NPRS), pre and post Oswestry Disability Index (ODI) and pre and post muscle length via inclinometer and goniometer. Independent t-test for post treatment groups between stretching group and muscle energy technique group was not significant i.e. P> 0.05. Conclusion: The study concluded that statistically there is no significant difference in variables of both groups i.e. Numeric Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), bilateral muscle length of iliopsoas, hamstrings and rectus femoris as well as of erector spinae. However, mean values of above mentioned parameters show a little more improvement in Muscle Energy Technique group. Keywords: Stretching, Muscle Energy Technique, Lower Cross Syndrome, Muscle imbalance.
... Simple stretching method includes different stretches among which passive stretches also included. With the help and aid of an assistant, machine, therapist weight or pulley system one can uses forces externally to stretch the desired body tissue 12 . An advance type of stretching technique used to treat tight muscles is muscle energy technique. ...
Aim: To compare the effects of stretching exercises & muscle energy techniques in the management of lower cross syndrome. Methods: In this parallel, randomized controlled trail fifty-eight patients were randomly assigned into two intervention groups. Group A received stretching technique and Group B received muscle energy technique, three sessions per week for total duration of four weeks. Results: Normality test applied and P values were noted by applying Shapiro-Wilk test both groups. Baseline measures for both groups showed no significant difference as the P value > 0.05. The paired t-test within the group of Stretching and Muscle Energy Technique showed significant difference in pre and post Numeric Pain Rating Scale (NPRS), pre and post Oswestry Disability Index (ODI) and pre and post muscle length via inclinometer and goniometer. Independent t-test for post treatment groups between stretching group and muscle energy technique group was not significant i.e. P> 0.05. Conclusion: The study concluded that statistically there is no significant difference in variables of both groups i.e. Numeric Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), bilateral muscle length of iliopsoas, hamstrings and rectus femoris as well as of erector spinae. However, mean values of above mentioned parameters show a little more improvement in Muscle Energy Technique group.
... Additionally, working on laptops instead of desktops can cause people to lean over the screen. "Many clinical case reports published in the pandemic years, had demonstrated that poor posture can cause microtrauma and stress to the upper back and neck area, and leads to pain and discomfort (1,2,3,4), dizziness (5,6,7), numbness (8.9), gastrointestinal problems (10,11,12), and scoliosis (13-16)" Chu said. ...
... "Many clinical case reports published in the pandemic years, had demonstrated that poor posture can cause microtrauma and stress to the upper back and neck area, and leads to pain and discomfort(1, 2, 3, 4), dizziness (5,6,7), numbness (8.9), gastrointestinal problems (10,11,12), and scoliosis (13-16)," Chu said. "Kids and adults frequently spend hours crouched over their laptops, benching their necks to stare at their computers, desks, kitchen counters, and even in bed. ...
New York Medical Group (NYMG) published a 2022 case study in an University of Washington journal (17) which included an "S" shaped neck x-ray where researchers found a strong association between the text neck and neck deformity on x-ray. Sustained flexion of the neck will cause cervical spine distortion. Introduction: As the new waves of the Omicron variety gain strength in many parts of the world, it is evident that the old normal has slipped, and a new sense of normalcy is setting in. This has been evident with the arrival of the work-from-home, study-from-home and socialize-from-home model, whenever possible. Many patients now suffer from tech neck due to bad posture.
