Association between cervical sagittal alignment, neck awareness, and disability in chronic neck pain: The possible role of probable sleep bruxism

BackgroundChronic neck pain (CNP) is a major cause of disability. Cervical sagittal alignment, neck awareness, and probable sleep bruxism may influence symptom burden.MethodsThis cross-sectional study included 76 patients (18-60 years) with CNP. Probable sleep bruxism was classified using self/partner report and clinical findings. Pain was rated on a visual analog scale (VAS), neck awareness by the Fremantle Neck Awareness Questionnaire-Turkish (FreNAQ-T), and disability by the Neck Disability Index (NDI). Lateral radiographs provided C0-2 and C2-7 Cobb angles, cervical sagittal vertical axis (cSVA), T1 slope (T1S), T1S-cervical lordosis (T1S-CL) mismatch and cervical tilt.ResultsThirty-six patients had probable sleep bruxism. Patients with probable sleep bruxism were younger, more often desk-based workers, and had higher educational levels (p = 0.002, p = 0.002, and p = 0.008, respectively). They also had higher NDI scores (p = 0.043) and greater cSVA (p = 0.045). In the overall cohort, FreNAQ-T correlated with NDI (r = 0.585, p < 0.001), and night pain correlated with FreNAQ-T (r = 0.266, p = 0.020) and NDI (r = 0.253, p = 0.028). In patients without probable sleep bruxism, C2-7 Cobb angle correlated with T1S (r = 0.322, p = 0.035) and T1S-CL mismatch (r = -0.718, p < 0.001). In those with probable sleep bruxism, night pain correlated with C2-7 Cobb angle (r = -0.347, p = 0.038) and cSVA (r = 0.336, p = 0.045).ConclusionProbable sleep bruxism was associated with higher disability and greater anterior cervical sagittal translation in CNP. Subgroup-specific correlation patterns suggest associations among sagittal alignment, neck awareness, and symptom burden; however, causality cannot be inferred.