What is it about?
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 sharp pain in the neck, upper back, and sternum area for 4 weeks and gastroesophageal reflux disease (GERD). She had been working at home for several months after the shelter at home order was issued. Following evaluation and corrective treatment with cervical adjustment and soft tissue massage, the patient’s posture improved and reported full pain resolution. Her symptoms of GERD concurrently resolved as well. She continued to receive chiropractic adjustment two times per month for correcting spinal misalignment. Full restoration of posture was attained on the full spine radiographs at 9 months follow-up. The patient remained symptom-free at 12 months follow-up. Manipulative and preventive therapies aimed at treating and preventing UCS should be more widely adopted to prevent secondary conditions.
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Why is it important?
Presented is a case of upper cross syndrome with coexisting GERD. GERD is secondary to the musculoskeletal changes resulting from prolonged periods of working from home during the peak of the COVID-19 pandemic. While the musculoskeletal abnormalities and GERD were corrected with appropriate therapy, this case demonstrates that a sedentary lifestyle plays a significant role in the population being more susceptible to additional pathological conditions when posture is compromised from repetitive and excessive sitting.
Perspectives
A 35-year-old female graphic designer presented with sharp pain in the neck, upper back, and sternum area of 4 weeks duration. The pain radiated to substernal, interscapular, and subscapular areas as a gripping and squeezing sensation without numbness. The symptoms were worse in the evening, and lying on her back while sleeping aggravated the pain. Her medical history indicated a chronic history of neck pain, heart burn, acid reflux, and period pain. After the lock-down during the pandemic, she remained inside her apartment and reported sitting on the bed at her computer while working. Her neck pain gradually became severe and was rated at 8/10 on a numeric pain scale. Her laboratory, barium swallow study and orthopedic tests were negative and ruled out major visceral pathology. The patient reported supragastric belching and regurgitation for at least six months and sometimes experienced a burning sensation in the chest. Changing position from sitting to standing could partially relieve acid reflux. She denies dysphagia, vomiting or blood in her stool. Upper gastrointestinal endoscopy performed two months prior revealed mild inflammation in the distal esophagus and at the gastroesophageal junction, compatible with gastroesophageal reflux disease (GERD). She was prescribed antacids, histamine 2 receptor blockers, and dietary restriction which provided temporary relief only for the heartburn. The patient then sought chiropractic care for her neck pain.
Dr Eric Chun-Pu Chu
New York Medical Group
Read the Original
This page is a summary of: Resolution of Gastroesophageal Reflux Disease Following Correction for Upper Cross Syndrome—A Case Study and Brief Review, Clinics and Practice, May 2021, MDPI AG,
DOI: 10.3390/clinpract11020045.
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