As a dentist, I have treated many patients with retrusion of the lower jaw (commonly referred to as "TMJ or TMD" - poor term). This retrusion results in forward head posture affecting the neck and shoulders with a probable referral to the Vagus nerve in the spinal cord. An X-ray of the head and neck, in profile, will show the status of the cervical spine which normally has a curvature of about 17 degrees. In FHP, this curvature is lost and the cervical spine is straight, or even bent slightly forward. since the Vagal nerve has effect on the intestines, this is a probable cause although I am unaware of any definitive studies. There are also other conditions/symptoms related to this condition.

35 Replies

  • Hi BRdog59, Now you have defiantly got my attention.

    I've suffered IBS for over 13yrs,and I've always believed there has to be a cause for constant pain. So having been on this site for awhile now a Man once mentioned to me to look into the Vagus nerve. This is after I've been through all there is to go through tests diets ect ect. Well I'm seeing a Proffesor of Gastrology at the moment,and he has given me a phone No for if I was in to much pain I could phone.

    So about a month ago I got to that stage and his nurse suggested I have an MRI scan for the Perenial nerve,and I metioned the Vagus nerve to her and she said we'll try this first. It's so strange how nerves can play such a big part in your bowels. I also have Osteoporosis,at the bottom of my spine.

    Sounds stupid but you've made me feel just maybe I've hit on the cause of my chronic bowel issues. Thank you for your post.

  • You're welcome! I hope that this leads to a cure. The Vagus also has an effect on the heart and stomach, so I've seen patients with cardiac arrhythmias and GERD due to the forward head posture the retrusion of the lower jaw creates. That is easily (and less than an MRI) visualized by a lateral cephalometric X-ray (profile) which shows the head and cervical spine. With retrusion, the normal curvature is lost and the cervical spine is straight or even a bit forward tilted. A less common occurrence with FHP is a form of thoracic outlet in which the arm experiences pain and/or numbness. My best wishes.

  • Thank you for your interesting post. What Dr. do you go to for these nerve

    problems cheated out?

    Thank You

  • Hi Andi4, You can ask any Dr your GP,your Gastrologist,consultant.

    Whoever your under in your area. Just ask if it's possible to have one at a time of these tests if you feel like me that is the course of your pain.

  • Thanks ..............I made an apt with a Nuro DR

    Does your IBS make your stomach really hard and swollen?

    What meds have you tried?

    Thanks for reaching out to me Gemini71 :)

  • You bet it does,I look 6mths pregnant,it's a bit of a joke in my household. I'm on a nerve blocker Pregablin,an Antidepressant ,none of which do any good and I've been on them 8-9yrs,but I'm struggling to get off them.

    As for any other drug I've tried them all.


    Now I take 1Diazapam after tea to relax me a bit,because the pain is pretty severe then. But quite honestly nothing has worked.

  • Oh one more point,andi,don't ever give up,if one test shows nothing try another,it's your right,don't suffer you want some answers.

  • I dislike using meds except where they affect a cure, such as antibiotics (with removal of the cause).

  • Very interesting. Thanks for the post - we need more medical professionals that work cross-specialization.

  • You're very welcome. Several others also wrote me and I gave them more information which you might find interesting. Another dog lover, I assume.

  • that is very interesting if this is causing the problem then can you please confirm if it is the spine or nerve is causing the bowel problems? and i would like to know so i can go to my GP about this.. as i am desperate to find out what is causing me to have severe abdominal cramps and diarrhoea and sometimes vomiting and also i have nearly every day... thanks

  • First step in any problem is a proper diagnosis. When the lower jaw (mandible) is retruded (back) the head comes forward and the cervical spine loses its natural curvature (lordsis) and becomes straight or forward bent. This is visualized on an X-ray taken in profile (lateral cephalometric). This is known to produce a "Vagal" effect, referring to the tenth cranial nerve which has effects on the heart, stomach and intestines. While this is a cause of problems associated with those organs, it is not the only cause; so, if you have confirmation of the FHP, you may want to bounce it around with your physician. I have also seen a form of "thoracic outlet": pain and/or numbness down the arm due impingement on the neurovascular bundle.

  • Well I know this much - I have constant gut issues / IBS and constant daily nexk and shoulder pain....

  • Chances are very good that you have identified the source. I believe that I mentioned that this could be confirmed by an X-ray taken in profile which shows the cervical vertebrae, which in forward head posture will be in a straight line or slightly forward bent instead of the normal curvature (lordosis). I just wrote a brief treatment plan for Cassie 17 which you might like to read as treatment is similar in all cases of correcting retrusion (positioned posteriorly). If you have any questions, shoot them to me.

  • Hi there thank you for your very helpful posts. I have IBS and palpitations. If I eat certain foods it affects my heart. I have had neck problem where I had a trapped muscle with took ages to go. Who do I speak to about what you are saying. My Doctor or my Dentist?

  • Anyone who can take an X-ray of the head and neck can verify if you are in Forward Head Posture, which is associated with the lower jaw being back (retruded). Treating the condition requires that you can confirm that the lower jaw is distal to where it should be and that the upper jaw is also properly positioned to the base of the cranium. This latter requirement is because (as you would have surmised) since the lower jaw is back it must be advanced to its proper position with respect to the base of the cranium. Some people, usually due to asthma or allergies, do not grow properly during the early years because they cannot breathe adequately through their nose and, therefore, mouth breathe. This puts the tongue on the floor of the mouth and does not rest between the developing arches of the upper jaw causing them to grow outward and forward. Once the lower jaw has been moved, orthopedically, there usually is some orthodontics required to get the teeth properly interdigitated (which insures that the skeletal relationship remains constant. If you would like for the same person to do all of the above, it obviously would not be a medical doctor, but a dentist: general practitioner that does orthodontics, or an orthodontist that understands orthopedic repositioning followed by the ortho.

    Do NOT let someone talk you into a surgical procedure which lines up teeth! This lengthens the jaw to line up teeth, but leaves the jaw retruded which is the cause of the problem to begin with. You could call around and ask questions to find the person. When you see the initial X-ray, the cervical spine will be straight (it usually has a backward facing curve) or possibly slightly bent forward, which indicates the lower jaw is retruded. If it is not, I would look for other possibilities, but check with a new X-ray some time later. If questions arise, don't hesitate to drop me a line.

  • Many thanks for such a detailed response. I do appreciate your time. My dentist has always said i have 'an abonormal bite' in that my top and bottom teeth don't meet. I don't know if over the years it has caused a problem. She said I am too old to wear a brace. I can mention all this to her and see what she says. Thank you.

  • Nonsense. I've treated people in their 60's. Unfortunately, many of my colleagues felt they had to memorize all that they were exposed and regurgitate it on demand to graduate. It is sad and true that not all that we were exposed to was correct (such as "you cannot expand anyone over 21" - I've expanded patients as old as 60 and I'm not alone). The only thing that age does is slow down the response by bone remodeling (harder due to more calcium - this is why youngsters fall with scrapes and the elderly have a simple fall and break hips, etc.). This is why you may need to interview several dentists: to determine their level of education in the subject. This is not a blanket endorsement, but there is an organization IAO (IAO.org) which has members who are familiar with the subject. They absorbed an organization to which I belonged (AAFO); but I do not know their level. If you contact them, you might get the names of a few members near you. Stay in touch. My best!

  • Thank you very much for your help.

  • you're very welcome. drop a line any time you have questions or I can help.

  • Very interesting,if this is the cause how can we correct it?thanks for your post.

  • Identifying the cause also identifies the cure, in this case, the lower jaw, the mandible, is retruded (back). Therefore, the mandible must be advanced to the proper relationship with the base of the cranium; and, this is achieved with a plastic appliance (a "bite block" as some call it). This is worn at all times, except when brushing. After 4-6 months, the musculature will have been retrained to close to the "new" relationship. At this time, usually, some orthodontics will be required to align the teeth in proper contact (while maintaining the skeletal relationship achieved). Once this is done, there is no longer any need for any appliance. Simply aligning the teeth together will not always work since the upper jaw, the maxilla, may itself be improperly aligned with the cranium. Therefore, prior to starting treatment, an X-ray, a lateral cephalometric, which shows the head and cervical vertebrae in profile is taken and the essential bones are traced out and the relationships are measured so that it is known whether the treatment goals can be met.

  • I would love it if this is all it takes. I'm not going to build my hopes up on the basis of "if it sounds too good to be true it probably is ".

  • As I mentioned to others who wrote, the first step is a proper diagnosis, without which one is only guessing. The cephalometric X-ray shows the head and neck in profile and one can readily see the cervical vertebrae. "If you can measure it, it is a fact. If you cannot measure it, it is an opinion." This is measureable. If the cervical vertebrae are in a straight line, you are in forward head posture and the chances of a "Vagal" effect are good. If the normal curvature is in place, this is not your problem. Best wishes!

  • Hi,BRdog,Tell me who is the best person to check all this for us.

    Would it be Gastrologist ,Dentist,or do you have to go through your GP.?

  • Oh I should add I also have cardiac problems as well ,so hopefully due to you we may have hit on something.

  • I am of the understanding that there may be more than one cause of IBS. I am a dentist and a number of my patients whom I treated for forward head posture due to retrusive position of the lower jaw (mandible) also had IBS which they were not aware could be related to the mandibular retrusion (distal position from the norm). FHP is identified on X-ray by the loss of the normal curvature of the cervical spine and the cervical spine being straight or even slightly bent anteriorly. If you have consulted other health care professionals about the IBS and have not found the cause, I suggest that you check for the FHP which can be responsible for a "Vagal" effect. The Vagus is a cranial nerve which affects the heart, stomach and intestines and can be affected by the FHP. The straight cervical vertebrae is diagnostic for FHP. I hope this helps and I wish you the best.

  • Thank you for that information,I will certainly look into what your saying.

    As I say a man just dropped out the Vagus nerve to me sometime ago,I did look it up and I could see his point but not being a medical person myself,I just dropped it out to my Gastrologists nurse,so I'll now take it from there.

  • Let me know how you fare.

  • I will,when I can get to see someone,my pain is now beyond a joke.

    Thank you for your help.

  • Hi BrDog, a very interesting post. I wonder if you could help me. I suffer from Trigeminal Neuralgia, and have recently been (semi!)diagnosed with having IBS. Previous to this though, I had gallstones, which seemed to create gut dysmotility, as in as soon as I had my first attack of biliary colic it was as if my gut had stopped working.

    Despite having my gallbladder out, this has never improved. My gut now feels as if it just doesn't have peristalsis occurring in it, and I suffer from chronic constipation, in spite of a very healthy high fibre diet.

    I have always felt my problems were connected, a type of degeneration, and I have wondered if something had damaged my autonomous nervous system. However, after reading your post, I now wonder if some kind of cervical spine displacement might be causing both the neuralgia and my gut problems. Many years back, before all this, I noticed my bite had changed; I could no longer bring my right-hand teeth together properly. I reported this to my then dentist, and have told my current dentist too, but neither was/is interested. I also have some kind of impact pain on my left-hand side molars, and chronically itchy inner ears which do seem to be related in some vague way to my bite.

    Anyway, this all seems too vague and far-fetched to take to my doctor and I just wondered if you thought there could be a connection. I also have what looks like a dowager's hump in profile - so much so I panicked for a while thinking it was Addison's Disease (I think that's the right one. It's a while since I researched it!) But it's not fat, it's just the top of my spine, like my neck was a collapsed C above it, rather than my spine going up into my head - if that makes any sense at all!

    Sorry for the mish-mash of info here; I'm just trying to give you all the oddities that I've wondered about. Reading your post felt like a light-bulb moment - but I am wary of light-bulb moments - they are often just wishful thinking! Any light you could throw on this would be most welcome.

  • If you have the forward head posture, it can be a cause of IBS and is easily identified by the straight cervical spine seen on (lateral) X-ray of the head and neck. Trigeminal neuralgia is a different entity and I have not come across any references of there being a connection between the two.

  • Thanks, BRdog, I asked because there is a school of thought that cervical spine compressions in the neck may be a cause of (some) TN. I just wondered if the two things might have been related.

  • If I can find anything more, I'll let you know.

  • I have not heard that; and, it does not seem plausible. Trigeminal neuralgia is so named because its effects follow the distribution of the trigeminal nerve (Vth cranial nerve) which exits the base of the skull to supply sensory and motor innervation to the face and muscles of mastication. Its branches are not in the cervical spine.

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