Chronic neck pain and its association with the angle of the cervical curve

Objective: This study was conducted to investigate the relationship between the angle of the cervical curve and the presence of chronic neck pain.
Material and Methods: Case control study was conducted among 363 patients, (females 76.9%), who had neck pain (>3 months) and 349 individuals, (females 58.5%), with no neck pain, aged 20-69 years. Angle of the cervical curve was measured in lateral x-rays of cervical spine using AutoCAD 2014 and cross checked by two Consultant Radiologists. Angle of the cervical curve was categorized as 35°-45°-normal lordosis, <35°-hypolordosis and >45°-hyperlordosis. Percentages of each category were calculated.
Results: Among the patients with chronic neck pain, 44.9% (n=163) had hypolordosis, 49% (n=178) had hyperlordosis and 6.1% (n=22) had the normal lordosis. Among the individuals with no neck pain, the majority (80.8%, n=282) had the normal lordosis, 12.3% (n=43) had hypolordosis and 6.9% (n=24) had hyperlordosis. Chi square test showed a statistically significant association between neck pain and the angle of cervical curve (p=0.001). According to Cramer’s V (0.615) there was a strong association between the two variables. For purposes of analysis both hypolordosis or hyperlordosis were categorized as atypical angle. When compared to individuals with a normal lordosis, those with an atypical angle have a 3.3 times risk of having neck pain.
Conclusion: Hypolordosis or hyperlordosis, atypical angle of the cervical curve contribute to chronic neck pain.