Could making their own cervical neck roll help relieve pain and improve sleep for individuals who have neck pain after sleeping or during sleep?
Sleep Cervical Neck Roll
Neck pain can lead to sleep loss, leading to various health problems. Neck pain and everything that comes with it can limit the ability to work, drive, or sleep normally. A cervical roll may be one way to keep your neck in the optimal position while sleeping. Many with neck pain require extra support from their pillow. A cervical pillow can provide that support.
For individuals who develop neck pain, a visit to a chiropractic physical therapist can help manage symptoms. Treatments and modalities like traction may be necessary to relieve pressure on cervical nerves. (Gudavalli M. R. et al., 2015) Steps to self-manage neck pain may include performing specific neck exercises and maintaining proper posture (Hesby B. B. et al., 2019). Using the right pillow with the right support can help keep the neck in correct alignment, decrease or eliminate neck pain, and get you back to normal activities.
Neck Support During Sleep
The neck comprises seven vertebrae bones, normally forming a slight curve called lordosis. Maintaining a forward curve in the neck is important when treating neck pain, as it can help relieve pressure on spinal discs and nerves. A cervical roll, also known as a neck roll or cervical pillow, is a small pillow placed in the pillowcase that supports the neck while sleeping. The cervical roll provides the right amount of support for the neck and maintains alignment while lying down. (Gross A. R. et al., 2013)
Individuals can purchase a cervical roll online or at a store or pharmacy.
Individuals can also contact a physical therapist to help them obtain a cervical roll.
Making Your Own
Making a cervical roll is simple to do. Here’s how:
Using a hand towel.
Fold it in half.
Slide the towel into the pillowcase along the lower edge.
Be sure the towel is tucked in so it doesn’t slip out.
Individuals can place tape around it so it stays in the rolled shape.
The towel roll will also help support the neck when lying on one side or the other, filling in the space between the head and shoulder. Sleeping on the stomach is usually not recommended for neck pain. Exercise and postural correction training are essential components of treatment for neck pain, and finding the right sleeping posture can help quickly eliminate pain. (Harvard Publishing, 2022)
If neck pain persists, worsens, or is accompanied by arm weakness or numbness and tingling, a visit to a healthcare provider may be necessary to assess the cause. A visit to a local chiropractic physical therapist can also help. They can immediately show you how to treat neck pain.
Injury Medical Chiropractic & Functional Medicine Clinic
A cervical roll can give your neck the right support while sleeping. This can help you quickly and safely manage neck pain and return to your previous level of function. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
The Road To Recovery: Chiropractic Care
References
Gudavalli, M. R., Salsbury, S. A., Vining, R. D., Long, C. R., Corber, L., Patwardhan, A. G., & Goertz, C. M. (2015). Development of an attention-touch control for manual cervical distraction: a pilot randomized clinical trial for patients with neck pain. Trials, 16, 259. https://doi.org/10.1186/s13063-015-0770-6
Hesby, B. B., Hartvigsen, J., Rasmussen, H., & Kjaer, P. (2019). Electronic measures of movement impairment, repositioning, and posture in people with and without neck pain-a systematic review. Systematic reviews, 8(1), 220. https://doi.org/10.1186/s13643-019-1125-2
Gross, A. R., Kaplan, F., Huang, S., Khan, M., Santaguida, P. L., Carlesso, L. C., Macdermid, J. C., Walton, D. M., Kenardy, J., Söderlund, A., Verhagen, A., & Hartvigsen, J. (2013). Psychological Care, Patient Education, Orthotics, Ergonomics, and Prevention Strategies for Neck Pain: A Systematic Overview Update as Part of the ICON Project. The open orthopaedics journal, 7, 530–561. https://doi.org/10.2174/1874325001307010530
Harvard Health Publishing. (2022). Say “good night” to neck pain. https://www.health.harvard.edu/pain/say-good-night-to-neck-pain
Discover effective treatment approaches for kyphosis, its causes and symptoms while enhancing your posture today.
Introduction
How often do you catch yourself slouching after hours at a desk or scrolling through your phone? Do you experience persistent neck strain, shoulder tightness, or upper back discomfort? While many people recognize poor posture as an annoyance, few realize that long-term postural dysfunction can contribute to kyphosis—a spinal condition characterized by excessive forward curvature of the thoracic spine.
As a nurse practitioner with 20 years of experience in physical medicine and musculoskeletal health, I have seen firsthand how kyphosis affects both young and older adults, often leading to pain, mobility limitations, and even systemic complications. With a background that includes chiropractic care integration, I emphasize a multidisciplinary approach to kyphosis treatment, focusing on conservative therapies that address spinal alignment, muscle strength, and postural control.
This article explores the environmental causes of kyphosis, its impact on the musculoskeletal system, and evidence-based treatment strategies, including chiropractic adjustments, physical therapy, and postural rehabilitation.
What is Kyphosis? Understanding the Spinal Deformity
Kyphosis refers to an excessive anterior curvature of the thoracic spine, exceeding 40 degrees. While a mild thoracic curve is normal, excessive kyphosis can lead to visible postural changes, musculoskeletal pain, and even respiratory or gastrointestinal complications in severe cases.
Types of Kyphosis
There are several classifications of kyphosis, each with distinct causes:
Postural Kyphosis: The most common type, usually seen in adolescents and office workers, resulting from prolonged slouching and weak spinal musculature.
Scheuermann’s Kyphosis: A more rigid spinal deformity due to wedge-shaped vertebrae, typically diagnosed in teenagers.
Osteoporotic Kyphosis: Common in older adults due to vertebral compression fractures from osteoporosis.
Congenital Kyphosis: A rare condition present from birth due to abnormal vertebral development.
If left untreated, kyphosis can progressively worsen, leading to significant postural, neurological, and functional impairments.
Environmental Factors Contributing to Kyphosis
While genetic predisposition plays a role in kyphosis development, environmental and lifestyle factors significantly contribute to the condition. Understanding these risk factors can help with prevention and early intervention.
1. Poor Posture & Prolonged Sedentary Behavior
Chronic slouching, improper ergonomics, and excessive screen time encourage adaptive shortening of the anterior muscles (pectorals and upper abdominals) while weakening the posterior chain (erector spinae and scapular stabilizers). This imbalance reinforces thoracic kyphosis over time.
2. Sedentary Lifestyle & Weak Core Stability
A lack of functional movement and spinal stabilization exercises leads to postural instability, increasing the likelihood of kyphotic progression. A weak core and underactive back extensors contribute to poor spinal support, leading to excessive forward bending of the thoracic spine.
3. Heavy Backpacks & Improper Lifting Mechanics
In children and adolescents, carrying overweight backpacks can accelerate kyphotic posture by exerting excessive downward pressure on the spine. Similarly, incorrect lifting mechanics in adults (e.g., repetitive forward bending with poor lumbar support) increase spinal stress, contributing to degenerative kyphosis.
4. Osteoporosis & Age-Related Bone Loss
Older adults, particularly postmenopausal women, are at a higher risk of developing osteoporotic kyphosis due to decreased bone density. Compression fractures in the thoracic vertebrae can lead to irreversible spinal deformity, making early bone health management critical.
5. Spinal Injuries & Degenerative Disc Disease
Trauma, herniated discs, and chronic spinal degeneration can disrupt normal vertebral alignment, leading to structural kyphosis. Degenerative changes in the intervertebral discs contribute to spinal instability, loss of disc height, and increased forward curvature of the thoracic spine.
Symptoms & Effects of Kyphosis on the Musculoskeletal System
Kyphosis not only alters spinal alignment but also leads to cascading effects throughout the musculoskeletal system. Depending on severity, symptoms may range from mild discomfort to functional disability.
Common Symptoms of Kyphosis
–Upper Back Pain & Stiffness: Chronic discomfort, particularly between the shoulder blades and mid-thoracic region. –Limited Mobility & Flexibility: A rigid thoracic spine reduces spinal extension, affecting overall movement. –Neck & Shoulder Tension: Forward head posture and rounded shoulders cause excessive strain on the cervical spine, leading to cervicogenic headaches and referred pain. –Muscle Fatigue & Weakness: Over time, kyphotic posture weakens the paraspinal muscles, reducing spinal endurance. –Breathing & Digestive Issues: Severe kyphosis can compress the thoracic cavity, leading to restricted lung expansion and impaired digestion.
Neuromuscular Impact of Kyphosis
Cervical Involvement: Increased kyphotic curvature forces cervical hyperextension, straining the posterior neck muscles and contributing to occipital headaches, vertigo, and TMJ dysfunction.
Thoracic & Lumbar Impact: Kyphosis can trigger compensatory hyperlordosis in the lumbar spine, increasing stress on the lower back and contributing to disc degeneration and sciatic symptoms.
Biomechanical Dysfunction:Altered gait mechanics, hip instability, and reduced balance have been observed in patients with significant kyphotic curvature (Lorbergs et al., 2017).
Understanding Long-Lasting Injuries- Video
Effective Treatment Approaches for Kyphosis
1. Chiropractic Care for Kyphosis Management
Chiropractic therapy is one of the most effective non-invasive treatments for managing kyphosis-related pain and improving spinal alignment. Research has shown that chiropractic spinal manipulation can improve mobility, reduce pain, and enhance postural stability (Norton et al., 2022).
Key Benefits of Chiropractic Adjustments:
1Spinal Realignment: Chiropractic adjustments restore normal vertebral positioning and reduce excessive thoracic curvature. –Improved Postural Control: Chiropractic care strengthens postural awareness, spinal mobility, and core stability. –Reduced Muscle Tension & Nerve Compression: Manual therapy alleviates trigger points, myofascial restrictions, and nerve impingements contributing to kyphotic discomfort. –Enhanced Flexibility & Range of Motion: Stretching techniques combined with spinal mobilization restore thoracic extension and shoulder mobility.
2. Physical Therapy & Postural Rehabilitation
Physical therapy plays a crucial role in strengthening the posterior chain, improving spinal stability, and reinforcing proper movement mechanics.
In adolescents with Scheuermann’s kyphosis, bracing can help prevent worsening curvature during growth phases.
4. Postural Ergonomics & Lifestyle Modifications
– Ergonomic Workstations:Maintaining neutral spine alignment while sitting reduces kyphotic strain. – Daily Mobility Exercises:Incorporating yoga, Pilates, or spinal decompression exercises can improve flexibility. – Weight Management & Bone Health Optimization:Vitamin D, calcium supplementation, and weight-bearing exercises support spinal integrity.
Final Thoughts: Addressing Kyphosis Proactively
Kyphosis is a progressive condition that requires early intervention and a multidisciplinary treatment approach. By combining chiropractic adjustments, targeted physical therapy, and ergonomic modifications, patients can significantly reduce pain, improve posture, and enhance spinal function.
Injury Medical Chiropractic & Functional Medicine Clinic
We associate with certified medical providers who implement the importance of the causes and symptoms of kyphosis. While asking important questions to our associated medical providers, we advise patients to integrate small changes into their daily routine to reduce the effects of kyphosis from affecting the cervical and thoracic areas. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.
References
Fortner, M. O., Oakley, P. A., & Harrison, D. E. (2017). Treating ‘slouchy’ (hyperkyphosis) posture with chiropractic biophysics((R)): a case report utilizing a multimodal mirror image((R)) rehabilitation program. Journal of Physical Therapy Science, 29(8), 1475-1480. https://doi.org/10.1589/jpts.29.1475
Jenkins, H. J., Downie, A. S., Fernandez, M., & Hancock, M. J. (2021). Decreasing thoracic hyperkyphosis – Which treatments are most effective? A systematic literature review and meta-analysis. Musculoskelet Sci Pract, 56, 102438. https://doi.org/10.1016/j.msksp.2021.102438
Lorbergs, A. L., Murabito, J. M., Jarraya, M., Guermazi, A., Allaire, B. T., Yang, L., Kiel, D. P., Cupples, L. A., Bouxsein, M. L., Travison, T. G., & Samelson, E. J. (2017). Thoracic Kyphosis and Physical Function: The Framingham Study. J Am Geriatr Soc, 65(10), 2257-2264. https://doi.org/10.1111/jgs.15038
Norton, T. C., Oakley, P. A., & Harrison, D. E. (2022). Improving the cervical lordosis relieves neck pain and chronic headaches in a pediatric: a Chiropractic Biophysics((R)) (CBP((R))) case report with a 17-month follow-up. Journal of Physical Therapy Science, 34(1), 71-75. https://doi.org/10.1589/jpts.34.71
Oakley, P. A., Gage, W. H., Harrison, D. E., & Mochizuki, G. (2024). Non-surgical reduction in thoracolumbar kyphosis and sagittal vertical axis corresponding with improved sensorimotor control in an older adult with spinal deformity: a Chiropractic Biophysics((R)) case report. Journal of Physical Therapy Science, 36(11), 756-764. https://doi.org/10.1589/jpts.36.756
Ogura, Y., Dimar, J. R., Djurasovic, M., & Carreon, L. Y. (2021). Etiology and treatment of cervical kyphosis: state of the art review-a narrative review. J Spine Surg, 7(3), 422-433. https://doi.org/10.21037/jss-21-54
Can understanding the anatomy and function of the long thoracic nerve help individuals make informed healthcare decisions after an injury to the nerve?
Long Thoracic Nerve
Also referred to as the posterior thoracic nerve, the long thoracic nerve/LTN is a thin superficial nerve that runs from the cervical spine to the chest wall side of the trunk. It supplies motor function to the thorax’s serratus anterior muscle, helping stabilize the shoulder blade. Injury to this nerve can cause limited or abnormal shoulder and shoulder blade motion, including difficulty raising the arm during overhead reaching.
Anatomy
The long thoracic nerve originates from the ventral rami of cervical nerves C5, C6, and C7. (Waxenbaum JA, Reddy V, Bordoni B. 2023) In some individuals, the root from C7 is absent; in others, a small nerve root branches from C8. The nerve roots from C5 and C6 go through the medial scalene muscle to join the C7 nerve. It travels behind the brachial plexus axillary artery and vein and courses down the lateral side of the thorax. The long thoracic nerve terminates at the lower portion of the serratus anterior muscle, sending small nerve tendrils to each muscle’s projections, which attach to the ribs. Because the long thoracic nerve is located on the lateral side of the chest, it is vulnerable to injury during sports or surgical procedures. The nerve also has a smaller diameter than other cervical and brachial plexus nerves, which increases its potential for injury.
Function
The long thoracic nerve attaches to the underside of the shoulder blade and inserts as muscular slips into the ribs. It supplies motor function to the serratus anterior muscle, essential for normal shoulder motion. When it contracts, it pulls the shoulder blade against the ribs and thorax, helping to move and stabilize the arm as it moves forward and up during shoulder motions. Injury to the long thoracic nerve causes a condition called scapular winging. This occurs when the serratus anterior muscle becomes weakened or paralyzed after injury. (Lung K, St Lucia K, Lui F. 2024)
Susceptibility to Injury
The LTN is relatively unprotected and can be damaged by several things, including:
Heavy backpacks
Sports
Activities the body is not used to, like digging
Using crutches
Conditions
Injury to the long thoracic nerve may occur as a result of trauma, lifting heavy weights above the shoulder, or a surgical procedure. Surgical procedures that may place the nerve at risk for injury may include: (Lung K, St Lucia K, Lui F. 2024)
Axillary lymph node dissection
Improperly placed intercostal drains
Chest tube placements
Mastectomy
Thoracotomy
The long thoracic nerve is protected during these procedures by the surgeon and proper surgical technique, but occasionally, difficulties arise during surgery, and the nerve may become injured. Individuals may also have an anatomical variance that places their nerves in varying positions. The surgeon may not see it and accidentally injure their nerves during surgery.
The superficial long thoracic nerve may also be injured during sports or trauma to the trunk. A blow to the side or a sudden overhead stretch to the shoulder may be enough to damage the nerve, paralyzing the serratus anterior muscle.
Weakness or paralysis of the serratus anterior muscle will result in a winged scapula. To test for this:
Stand about two feet from a wall, facing it.
Place both hands on the wall and gently push against it.
If one of the shoulder blades sticks out abnormally, it could be a winged scapula.
Have a family member or friend stand behind you and check the shoulder blade position.
If you suspect a winged scapula, visit a physician who can assess the condition and determine if there is a long thoracic nerve injury.
Winging the scapula may result in difficulty lifting the arm overhead. The serratus anterior muscle works with other scapular stabilizers, such as the upper trapezius and levator scapula, to properly position the shoulder blade when lifting the arm. Failure of the serratus to stabilize the shoulder blade may make lifting the arm impossible.
Clinical examination is usually used to diagnose a long thoracic nerve injury. X-rays and MRIs cannot show the nerve injury directly, although an MRI can show some secondary signs to help confirm the diagnosis. An electromyographic or EMG test may also be performed to examine the function of the long thoracic nerve.
Treatment and Rehabilitation
Treatment for LTN pain and reduced movement may include:
Rest
Heat or ice
Anti-inflammatory pain medication
Neck support or a pillow
Avoiding strenuous activity and driving
If the long thoracic nerve is severely injured and the serratus anterior is completely paralyzed, the best course of action is to be active and monitor the condition. Full recovery of arm function can take one to two years. If permanent nerve injury has occurred, surgery may be an option to restore shoulder motion and function. Several different kinds of surgery can be used to address winged scapula. (Vetter M. et al., 2017)
One involves transferring the pectoralis major tendon to the scapula (Vetter M. et al., 2017) so it functions as the serratus.
Often, the tendon has to be lengthened, which may be done using part of the hamstring tendon.
After surgery, individuals will likely wear a sling on their arm for a few weeks, and then gentle range-of-motion exercises will be initiated.
After eight to ten weeks, gentle progressive strengthening of the new tendon can begin.
Full shoulder motion and strength recovery are expected six to 12 months after surgery.
Lie on your back and raise both arms toward the ceiling.
Make a fist and punch up toward the ceiling.
Ensure the motion is steady and deliberate, and keep the elbow straight.
Hold the position for three seconds, then slowly lower the arm to the starting position.
Perform 10 to 15 repetitions.
Holding a small dumbbell in your hands can make the exercise more challenging.
Pushup
Lie on your stomach and place your hands flat on the ground by your shoulders as if you were going to perform a pushup.
Perform a pushup and press further, allowing the shoulder blades to wrap around the thorax.
Hold this position for three seconds, and slowly release.
Perform 10 to 15 reps.
If this is too difficult, perform the pushup against a wall to reduce the effect of gravity on the exercise.
Scapular Winging in Depth
References
Waxenbaum, J. A., Reddy, V., & Bordoni, B. (2024). Anatomy, Head and Neck: Cervical Nerves. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30844163
Lung, K., St Lucia, K., & Lui, F. (2024). Anatomy, Thorax, Serratus Anterior Muscles. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30285352
Vetter, M., Charran, O., Yilmaz, E., Edwards, B., Muhleman, M. A., Oskouian, R. J., Tubbs, R. S., & Loukas, M. (2017). Winged Scapula: A Comprehensive Review of Surgical Treatment. Cureus, 9(12), e1923. https://doi.org/10.7759/cureus.1923
Berthold, J. B., Burg, T. M., & Nussbaum, R. P. (2017). Long Thoracic Nerve Injury Caused by Overhead Weight Lifting Leading to Scapular Dyskinesis and Medial Scapular Winging. The Journal of the American Osteopathic Association, 117(2), 133–137. https://doi.org/10.7556/jaoa.2017.025
