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Upper Crossed Syndrome - Causes, Symptoms, Diagnosis, Treatment, and Prevention

Written by
Dr. Sneha Kannan
and medically reviewed by Dr. Shakti Mishra

Published on Oct 24, 2019   -  5 min read



Do you have neck pain, back pain, chest tightness, and headache when you sit for a long time in front of your computer or TV? It can be signs of upper crossed syndrome. For more information, read the article.

Upper Crossed Syndrome - Causes, Symptoms, Diagnosis, Treatment, and Prevention

What Is Upper Crossed Syndrome?

When poor posture deforms the muscles in the neck, shoulders, and chest, it is called upper crossed syndrome or UCS. It makes these muscles overlap, overactive, or underactive. Upper trapezius and levator scapula, which are thUpper Crossed Syndromee muscles of the neck and shoulders, become overactive and strained. The major and minor pectoralis muscles that are the muscles in the front of the chest become tight and short. Because of this deformation, the surrounding muscles become weak and underused. This condition results in the muscles in the front of the neck and lower shoulders to become weak.

UCS is commonly seen in people who have desktop jobs, read, or drive, as they usually slouch while performing these activities. It commonly causes neck and back pain and stiffness. Stretching and strengthening exercises can help relieve these symptoms. It is not a serious condition, but it can lead to chronic pain, so it is important to get it treated.

What Are the Causes of Upper Crossed Syndrome?

Any of these following factors can cause UCS:

  • A sedentary lifestyle with poor posture - People who spend long hours in meetings or in front of a computer with long commutes and frequent travel are more prone. These people slouch, that is, they sit with their head bent forward and upper back hunched.

  • Poor exercise technique - Unbalanced training like doing bench presses thrice a week but not doing push-ups or spending half of each workout doing crunches with the head bent forward, can overwork certain muscles in the neck and shoulders, resulting in UCS.

Poor posture while reading, watching TV, driving, etc., can also cause this condition.

What Are the Muscles Affected in Upper Crossed Syndrome?

Because of improper posture, the following muscles become stretched or tight:

  • Suboccipitals.

  • Upper trapezius.

  • Levator scapulae.

The pectoral muscles become short and tight. The deep cervical flexors, the muscles on the front and sides of the neck, become weak. The name upper crossed syndrome is derived from the “X” shaped that forms when the overactive and underactive muscles overlap.

What Are the Muscles Affected in Upper Crossed Syndrome?

What Are the Symptoms of Upper Crossed Syndrome?

UCS results in the following symptoms:

  • Neck pain.

  • Headache.

  • Muscle weakness in the front of the neck.

  • Muscle strain in the back of the neck

  • Upper back and shoulder pain.

  • Chest pain and tightness.

  • Jaw pain.

  • Fatigue.

  • Low back pain.

  • Pain while sitting and reading.

  • Problems driving for long periods.

  • Restricted neck and shoulder movement.

  • Rib pain.

  • Reduced movement in the ribs.

  • Numbness and tingling sensation in the upper arms.

How Is Upper Crossed Syndrome Diagnosed?

Your doctor will diagnose this condition based on certain identifying characteristics. The common characteristics include:

  • Head consistently bent in a forward position.

  • Increased cervical lordosis (the cervical spine is too curved).

  • Increased thoracic kyphosis (the outward curvature of the spine in the upper back, shoulders, and chest is more).

  • The shoulders are elevated, protracted, or rounded.

  • Scapula winging (the shoulder blade sits out).

If you have the above symptoms along with these characteristics, you most like have UCS.

What Are the Treatment Options for Upper Cross Syndrome?

The treatment options include:

Physical therapy - A physical therapist will first educate you and give advice related to your condition, so you understand the cause and work towards preventing more damage. The therapist will demonstrate exercises that you need to do regularly at home. They might also relieve pain and stiffness by manual therapy. Some of the exercises that you might have to do are:

  • Lying exercises - Place a thick pillow under the back about a third of the way up to your back while you lay flat on the ground. Keep your arms, shoulders, and legs fall out in a natural position. You can use a pillow to support your head, as to avoid it from stretching or straining. Maintain this position for 10 to 15 minutes. Repeat this exercise several times a day.

  • Sitting exercises - Keeping your back straight, sit and place your feet flat on the floor and bend your knees. Keep your palm flat on the ground behind the hips. Now, rotate your shoulders backward and down. Maintain this position for 3 to 5 minutes and keep repeating this exercise as many times as you can.

  • Standing exercises - Stand with your feet apart, and turn your right foot out 90 degrees, and rotate your left foot inwards to about 30 degrees. Try placing your arms at shoulder height in line with your legs. You should then turn your head to look at your right fingers and bend your right knee as much as you can while keeping your left leg and torso straight.

Chiropractic care - Muscle weakness and poor posture can also misalign the joints in your spine. A chiropractor can realign these joints with spinal manipulation or adjustment. Always get this done by a licensed practitioner. Chiropractic care can also increase the range of motion, as it stretches and relaxes the shortened muscles.

What Are the Ways to Prevent Upper Cross Syndrome?

Some ways to prevent upper cross syndrome are:

  • Avoid activities that require bending the head forward for a long time.

  • Take frequent breaks while sitting or working on computers (preferably every 15 to 20 minutes).

  • Walk or swim for 30 minutes daily.

  • Spend less time watching TV, reading, using computers, and driving.

  • Do exercises that stretch the sore muscles of the neck, shoulders, and chest.

  • Use a lumbar roll in chairs.

  • While answering long phone calls, use a headset or speakers.

  • Use a pillow that retains its shape.

  • Avoid doing things that aggravate the pain and discomfort.

  • Do strengthening exercises that target the muscles of the shoulders and neck.

  • Keep book, TV, or computer screen at your eye level.

Stretching Exercises:

  • Upper cervical stretch.

  • Rhomboid muscles and trapezius muscle stretching is of utmost importance.

  • 'Yes' and 'No' nodding movements of the head can be performed while sitting.

  • Push-ups and wall press can also be included.

  • Pectoralis major and minor muscle stretching are required.

  • Maintain posture with correcting in mirror and back support.

You can prevent this condition by maintaining proper posture. If you feel your posture is wrong or if you are experiencing symptoms of UCS, consult a doctor online.

Last reviewed at:
24 Oct 2019  -  5 min read




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