What is text neck?
In our world, smartphones, tablets, computers and e-readers have increased in popularity and become an integral part of many people’s lives. As we find ourselves more reliant on these technologies, there has been an increased look at how our use of these devices effects our bodies. Coined in 2015, “text neck” describes neck pain associated with smartphone and tablet use. Different research groups around the world have been studying this phenomenon.
How are neck pain and smartphone use connected?
When we use smart phones, we end up with prolonged flexion of our neck or bending of the neck in a downward position. This position causes increased anterior (forward) curve of the lower cervical vertebrae (upper most bones of the neck) and is a recognized form of poor posture. This position also leads to more stress on the cervical spine, which can lead to muscle spasms or tightness.
The degree of flexion is associated with increased neck stress. It was predicted that with 15 degrees, the forces on the neck are 27 pounds, at 30 degrees 40 pounds, at 45 degrees 49 pounds and at 60 degrees 60 pounds. This is also more concerning with children as their heads are in larger proportion compared to their bodies. Studies have also shown that neck flexion angle is greatest with texting compared to other mobile phone activities. There have been numerous studies looking into associations between neck pain and smart phone use with a majority showing increased neck pain with increased smart phone usage. In some studies, as high as 80% of the participants had neck pain associated with significant flexion.
(Fares, 2017)
Other researchers are studying other effects on the body of positioning during texting. Some preliminary data shows increased changes in lower spinal positions and decreased lung capacity.
As the term “text neck” becomes more popular more studies are being done, with more recent studies showing no association between neck position and reported pain symptoms in adolescents. However, they do show some association in adults. Unfortunately, these studies are short term and caution that long term poor posture and forward flexion in adolescence could lead to neck pain in the future.
How can texting/smartphone use effect other injuries with neck pain?
With studies ongoing about the true effect of texting on body posture and pain symptoms, the question remains on how extended neck flexion can affect injuries with known neck pain. For instance, many people with concussions or overuse injuries from throwing have concurrent neck or shoulder pain. There are not many studies that address this issue directly, though it stands to reason putting more strain on already strained or sprained muscles would cause more damage.
One interesting pilot study does examine factors related to decreasing concussion risks and has found that neck strength can actually decrease concussion risk in high school basketball, soccer and lacrosse players. However, research about this should be expanded and investigated more as smartphones and screens are so entwined in our daily lives and that of student athletes.
What do I do to prevent or help with neck pain?
1. Work on posture!
It is important to keep a neutral neck and keep your spine and neck straight. One way to do this is have your screens at eye level.
2. Stretch and strengthen your neck.
Take time for breaks and stretch your neck in all directions to help keep muscles loose. You can also work on neck strengthening exercises to help stabilize your head.
3. Work on stabilizing your shoulder blades.
An easy way to do this is keeping good posture while you bring your shoulder blades together!
Other stretches can be found under patient information under the back and spine heading.
References:
Al-Gharabawi, B. Text Neck Syndrome: A New Concern for Physical Therapists Worldwide. EC Orthopaedic. Published 2017 Nov 09. Pg 89-91
Collins, C.L., Fletcher, E.N., Fields, S.K. et al. Neck strength: a protective factor reducing risk for concussion in high school sports. J Primary Prevent . Published 2014 Oct. doi: 10.1007/s10935-014-0355-2.
Fares J, Fares MY, Fares Y. Musculoskeletal neck pain in children and adolescents: Risk factors and complications. Surg Neurol Int. 2017;8:72. Published 2017 May 10. doi:10.4103/sni.sni_445_16 N.F
Hassan, K.A., Abdelmajeed, S.F. et al. The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis. Curr Rev Musculoskelet Med. Published 2019 Nov 26. doi: 10.1007/s12178-019-09594-y
Jen-Gwo Chen, Shu-Kai Wu, Hsiao-Ping Chiu, Chia-Nai Tu, Chien-Hsiou Liu. Evaluation of Three Tablet Computers at Two Levels of Ambient Illumination. International Journal of Human–Computer Interaction. Published 2015 Oct 02; 32(5), pages 394-401. Doi: 10.1080/10447318.2015.1064639
Kietrys, D.M. Gerg, Michael, et al. Mobile input device type, texting style and screen size influence upper extremity and trapezius muscle activity, and cervical posture while texting. Applied Ergonomics. Published 2015 Sep. doi: 10.1016/j.apergo.2015.03.003
Neupane S, Ali U, Mathew A. Text Neck Syndrome – Systematic Review. Imperial J Interdiscipl Res. Published 2017;3(7):141-8
Shah, Priyal P., and Megha S. Sheth.. Correlation of Smartphone Use Addiction with Text Neck Syndrome and SMS Thumb in Physiotherapy Students. International Journal Of Community Medicine And Public Health, published 2018, p. 2512., doi:10.18203/2394-6040.ijcmph20182187.
Toh SH, Coenen P, Howie EK, Straker LM. The associations of mobile touch screen device use with musculoskeletal symptoms and exposures: A systematic review. PLoS One. 2017;12(8):e0181220. Published 2017 Aug 7. doi:10.1371/journal.pone.0181220
Xie YF, Szeto G, Madeleine P, Tsang S. Spinal kinematics during smartphone texting – A comparison between young adults with and without chronic neck-shoulder pain. Applied Ergonomics. Published 2018 April. Pg 160-168. Doi: 10.1016/j.apergo.2017.10.018.
By Shanti Bhatia and Alee Vladyka
