Impact of physical exercise (strength and stretching) on repairing craniovertebral and reducing neck pain: A systematic review and meta-analysis

The craniovertebral (CV) junction is crucial for head support, mobility, and protecting the upper spinal cord and vital nerve structures. Disorders in this area can cause severe symptoms such as neck pain, restricted movement, and neurological issues such as headaches and balance problems. Exercise and physical activity improves muscle strength, flexibility, joint stability, reducing pain, and enhancing joint function, while specifically for the CV junction, exercise can relieve muscle tension, boost blood flow, and improve posture, although the specific impact on CV junction health remains underexplored. A comprehensive literature search was conducted using databases MEDLINE, Cochrane, Lilacs, and ScienceDirect, alongside manual searches through reference lists. The review focuses on exercise and CV junction issues and includes randomized controlled trials, cohort or case-control studies, and systematic reviews. Primary outcomes include pain levels, joint mobility, function, and quality of life. Results yield four meta-analyses with corrective exercise and conventional exercise in improving forward head posture risk difference 0.00 (-0.09, 0.09) 95% confidence interval (CI), between cervical and thoracic exercises odds ratio 1.04 (0.59, 1.84) 95% CI. Comparing exercise treatment and physiotherapy showed risk difference 0.11 (-0.10, 0.32) 95% CI and the comparative analysis between training and no treatment showed risk difference 0.09 (-0.01, 0.20) 95% CI. Exercise-based rehabilitation programs tailored to patients with CV junction problems offer robust evidence, benefiting clinical management, and prevention efforts.