Biomechanical Significance Of Mechanical Neck Pain Associated With Obesity: A Narrative Review

Abstract

Mechanical neck pain (MNP) is a musculoskeletal disorder commonly exacerbated by obesity. Obesity causes postural changes, such as forward head posture (FHP), which elevates mechanical loading to the cervical spine, accentuating neck pain. This narrative review discusses the biomechanical significance of MNP in the context of obesity. It synthesises existing literature on postural change, muscular dysfunction, and increased spinal burden with systemic inflammation associated with obesity to understand their role in the pathophysiology of MNP. Obesity contributes to postural changes like FHP, elevating mechanical loading on the cervical spine. Central obesity, with visceral fat increase, shifts the body’s centre of mass, increasing cervical spine stress and altering muscle activation patterns. These changes result in the underactivation of deep cervical flexors and overactivation of the superficial muscles, which are the sternocleidomastoid and upper trapezius, leading to pain and fatigue. Increased adiposity promotes systemic inflammation, further sensitising pain pathways. Weight control is emphasised as important for MNP prevention, with diet and exercise reducing mechanical load, pain, and inflammation. Correction of posture, such as scapular stabilisation and deep cervical flexor exercises, helps normalise muscle function and posture. Ergonomic workplace adjustments are also necessary for diminishing FHP and preventing cervical spine stress. Therefore, prevention and management of MNP rely on targeted interventions addressing obesity, highlighting need for further research into its biomechanical impact on the cervical spine.