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  • Writer's pictureDr Josh Bonine DC

Head Position Influences Chronic Symptoms

Head Position Influences Chronic Symptoms

In an article by Tominaga, Maak, Ivancic, Panjabi, and Cunningham (2006), the authors looked at whether a rotated head posture at the time of impact would influence patients' symptoms in a rear end collision. The authors stated, “A rotated head posture at the time of rear impact has been shown to be associated with a higher incidence and greater severity of chronic radicular [nerve root] symptoms compared with rear impact occurring when and occupant is facing forward” (Tominaga et al, 2006, p.380).

The intervertebral foramen is the beginning of the neural canal or tunnel through which the nerve passes and is formed by two adjacent vertebrae. The cervical nerve roots and ganglion are located within the neural canal. These sensitive structures, when compressed, can cause pain and other neurological negative sequellae along the distribution of that nerve. This study showed, “Significant C5–6 and C6–7 foraminal width narrowing due to head-turned rear impact can potentially compress the cervical ganglia and nerve roots causing injury and leading to chronic radicular symptoms, especially in individuals with stenotic spines” (Tominaga et al., 2006, p.384).

This study focused on the changes in the foramen as a result of the head being turned at the time of impact. Knowing the position of the patient’s head at the time of impact is important when correlating the patient’s symptoms to the mechanism of injury. This study provides support that the head being turned at the time of impact can result in chronic symptoms leading to permanency and persistent functional loss.


Spine & Injury Centers of San Antonio is a local network of 5 chiropractic offices. As a group, we are raising the standard of care for injured patients and their families.

If you have recently been in a car accident, or had a personal injury, sports injury, or exercise injury, and are experiencing back pain, neck pain, knee pain, whiplash, headaches, leg pain, etc, our San Antonio injury chiropractors can help!

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Tominaga, Y., Maak, T. G., Ivancic, P. C., Panjabi, M. M., & Cunningham, B. W. (2006). Head-turned rear impact causing dynamic cervical intervertebral foramen narrowing: Implications for ganglion and nerve root injury. Journal of Neurosurgery: Spine, 4(5), 380–387.



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