Does Chronic Neck Pain Matter? Auditory Function in Individuals With Forward Head Posture: An Exploratory Cross-Sectional Comparative Study.

BACKGROUND

Evidence suggests that neck pain and cervical pathologies may contribute to auditory disorders; however, auditory functions in individuals with forward head posture (FHP) have been insufficiently studied. This study aimed to explore hearing thresholds, self-reported auditory difficulties, central auditory processing measures, and the presence of tinnitus and hyperacusis in individuals with FHP with and without chronic neck pain compared with controls.

METHODS

Fifty individuals with FHP were included and classified into two groups according to the presence of nonspecific chronic neck pain: FHP with neck pain and FHP-only. Fifty individuals without FHP or neck pain constituted the control group. Tinnitus presence was recorded in all participants. Hearing levels were assessed using pure-tone audiometry, and subjective hearing difficulties were evaluated with the Turkish version of the Amsterdam Inventory for Auditory Disability and Handicap (T-AIADH). Central auditory processing was examined using the Modulation Detection Test (MDT) and the Temporal Fine Structure-Adaptive Frequency (TFS-AF) test. Sound tolerance was assessed using the Khalfa Hyperacusis Questionnaire.

RESULTS

No significant differences were observed among the groups in pure-tone hearing thresholds, MDT, TFS-AF, or hyperacusis scores (p > 0.05). However, T-AIADH scores were significantly higher in the FHP with neck pain group than in the other groups (raw p = 0.022; Holm-adjusted p = 0.044). Tinnitus prevalence was also significantly higher in this group (p = 0.003).

CONCLUSION

This study did not detect significant differences in objective auditory measures among individuals with FHP-only and controls. However, individuals with FHP and neck pain reported greater subjective hearing difficulties and a higher prevalence of tinnitus, highlighting the importance of considering neck pain in FHP evaluation.