Military Neck (Cervical Kyphosis)

Medically reviewed by Alana Biggers, MD on November 27, 2017Written by Ana Gotter on November 27, 2017

What is military neck?

Military neck is an abnormal curve of the cervical spine that causes you to look like you’re “standing at attention.” The condition, called cervical kyphosis, doesn’t have anything to do with serving in the military. It can be caused by:

  • a degenerative disc disease
  • an iatrogenic disorder
  • a congenital disorder
  • bodily trauma

Cervical kyphosis can mean your neck is either abnormally straight or bent backward. However, people with military neck have a neck that is abnormally straight.

Military neck

What symptoms does military neck cause?

The following symptoms can accompany military neck:

  • stiffness
  • decreased range of motion
  • headaches
  • pain in the neck and the extremities (fingers and toes)
  • coordination problems
  • muscle weakness
  • spine deformity
  • paralysis
  • bladder and bowel control issues

Not everyone with military neck will experience the same symptoms. Paralysis, bladder control issues, and bowel control issues are only present in extreme cases, especially when the condition is left untreated.

What causes military neck?

The most common cause of military neck is poor posture, either when awake or when sleeping. Poor posture can result from staring at the computer, occupational conditions, or repetitive movements. However, the condition can develop from other factors as well, such as:

Degenerative disc disease

As you age, your intervertebral discs begin to degenerate. This causes the discs in your spine to grow thin and collapse.

This change to the spine can alter your neck’s natural curvature and cause an imbalance due to the weight of your head. Degenerative disc disease usually increases in severity as you get older.

Iatrogenic disorder

Military neck can be iatrogenic, meaning it’s an unintended result of a medical procedure. The most common of these procedures is a laminectomy, which is performed to relieve pressure in the spine.

Removing the lamina creates more space for nerves, but it can also cause the facet joints between the vertebrae to be unstable. This complication is seen most often in children who undergo the procedure, as opposed to adults. Iatrogenic disorder can also arise from an unsuccessful cervical spine fusion, in which the fusion is too short.

Congenital disorder

A congenital disorder is one that occurs from birth, otherwise known as a birth defect. Those whose cervical kyphosis is congenital usually have complications in other parts of the body as well, such as urinary or kidney defects.

When military neck is a result of a congenital disorder, such as the spine not forming completely, the spine grows abnormally and the vertebrae create a triangle shape as they grow. This places an unnatural curve on the neck and stacked vertebrae.

Trauma

Trauma can also cause military neck. Different types of injuries can cause the trauma, including a car accident, a fall, or a sports injury. If the ligaments fracture or tear, the spine can curve forward and the spinal cavity might narrow.

The compression might cause the body of the vertebrae to heal in the shape of a wedge, creating an imbalance. In serious cases, you might experience neurological problems from the narrowing of the spinal canal, called spinal stenosis. Compressed pressure can cause numbness, pain, and muscle weakness.

How is military neck diagnosed?

Doctors diagnose military neck using various methods. Your doctor will ask about your medical history and the symptoms you’re experiencing.

Then, they will perform a physical exam. They may order imaging tests, such as an X-ray, MRI, or CT scan.

There are no exact measurements for how the neck should be aligned, so diagnosis is made if the curve of your neck is less than 20 degrees or more than 40 degrees.

How is military neck treated?

Physical therapy, a neck brace, and mild pain medications are generally prescribed for treatment, unless the curve of the neck is pressing on the spinal cord, in which case the doctor will likely recommend surgery. The most common surgery for cervical kyphosis is spinal fusion.

Physical therapy, which is prescribed either as a standalone treatment or after surgery, may include specific neck exercises to strengthen the muscles, such as cervical lateral flexion, cervical flexion and extension, and cervical rotation. The physical therapist may also perform neck traction, in which the neck is slightly extended.

For at-home treatments, your doctor or physical therapist may recommend that you do the following:

  • Rest your neck. Rest can help alleviate pain and promote healing, especially if your condition stems from repetitive motions or occupational circumstances. Avoid activities that aggravate your neck. You may also be prescribed a neck collar to limit movement.
  • Position your neck. A special contour pillow can help to correctly position your neck while you sleep. A rolled towel or a commercial neck roll can also be used; slide it inside your pillowcase to support the curve of your neck. Your therapist might also suggest using certain positions to help alleviate arm pain that radiates from your neck.
  • Apply ice. Ice packs and ice bags can help alleviate pain. Your doctor or physical therapist will probably suggest using the ice for 10 to 15 minutes at a time. You can also massage the area by rubbing an ice cup or ice cube on the sore spot.
  • Apply heat. A heating pad, hot pack, or hot bath or shower can all be beneficial. Heat often works best when applied for 15 to 20 minutes at a time.
  • Check your ergonomics. Make sure your work environment is set up in a way that allows you to position your neck correctly. This may involve changing the height of your desk, the location of your computer screen, or the type of chair you use.

What is the outlook for military neck?

The overall outlook for those with military neck is quite good. People usually respond well to physical therapy, lifestyle changes, and surgery when needed. After surgery, people are generally able to resume normal activities upon recovery, though they may need to wear a brace for up to three months. Clinical trials are currently being conducted to improve surgical fusion, in an attempt to make the procedure and recovery even more efficient.

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