Fortunately I dont have back or neck problems where I would need a special strap but I imagine this one could help.This is a great saxophone neck strap. The padding makes it comfortable and it has served me well for 6 years. Possibly the best feature is the hight adjustment buckle which allows instant adjustment to allow for clothing, different sized saxes etc.without slipping. I have other straps but this is the one I prefer to use. Sorry, I can't think of any cons.