Text neck is the term used to describe the neck pain and damage sustained from looking down at your cell phone, tablet, or other wireless devices too frequently and for too long.
Recently, a patient came into my practice complaining of severe upper back pain. He woke up and was experiencing severe, acute upper back muscle strain. I told him I believe the pain is due to his hours hunched over his cell phone. Diagnosis: Text neck.
This posture of bending your neck to look down does not occur only when texting. For years, we’ve all looked down to reading. The problem with texting is that it adds one more activity that causes us to look down—and people tend to do it for much longer. It is especially concerning because young, growing children could cause permanent damage to their cervical spines that could lead to lifelong neck pain.
Text neck most commonly causes neck pain and soreness. In addition, looking down at your cell phone too much each day can lead to:
Some studies suggest that text neck may lead to chronic problems due to the early onset of arthritis in the neck.
Poor neck posture of all kinds, not just from texting, can lead to strain or sprain.
A recent study shows that 79% of the population between the ages 18 and 44 have their cell phones with them almost all the time—with only 2 hours of their waking day spent without their cell phone.1
First, prevention is key. Here are several pieces of advice for preventing the development or advancement of text neck:
Keeping the neck straight and your phone at eye level can help prevent text neck.
Many people don’t know this, but you need to have strong core muscles—the abdominal and lower back muscles—to support your upper body, including your neck. Your core muscles usually do not get enough exercise during normal daily activities, so you need to do specific exercises to target these muscles.
You also need strong and flexible muscles in the neck to minimize strain on your cervical spine and help support the weight of your head. Again, your neck will not get sufficient stretching and strengthening during normal daily activities, so it is best to learn specific neck exercises with the help of a health professional.
Some people will also benefit from a more comprehensive treatment plan, such as a combination of manual adjustments, massage therapy, and cold laser therapy.
( Los Angeles Times) Dr. Dean Fishman, a Florida chiropractor, examined an X-ray of a 17-year-old patient’s neck in 2009 when he noticed something unusual. The ghostly image of her vertebral column showed a reversal of the curvature that normally appears in the cervical spine — a degenerative state he’d most often seen in middle-aged people who had spent several decades of their life in poor posture.
“That’s when I looked over at the patient,” Fishman says. She was slumped in her chair, head tilted downward, madly typing away on her cell phone. When he mentioned to the patient’s mother that the girl’s posture could be causing her headaches, he got what he describes as an “emotional response.” It seemed the teen spent much of her life in that position. Fishman says, “I knew I was on to something.”
The flexed neck can put a strain on cervical disks. (Zephyr / Getty Images/Brand X)
He theorized that prolonged periods of tilting her head down to peer into her mobile device had created an excessive strain on the cervical spine, causing a repetitive stress injury that ultimately led to spinal degeneration. He began looking through all the recent X-rays he had of young people — many of whom had come in for neck pain or headaches — and he saw the same thing: signs of premature degeneration.
Fishman coined the term “text neck” to describe the condition and founded the Text Neck Institute (text-neck.com), a place where people can go for information, prevention, and treatment.
“The head in neutral has a normal weight” of 10 to 12 pounds, says Fishman, explaining that the neutral position is ears over shoulders with shoulder blades pulled back. “If you start to tilt your head forward, with gravity and the distance from neutral, the weight starts to increase.”
A recent study in the journal Surgical Technology International quantified the problem: As the head tilts forward 15 degrees from neutral, the forces on the cervical spine and supporting musculature increase to 27 pounds. As the tilt increases, the forces increase to 40 pounds at 30 degrees, 49 at 45 degrees, and 60 at 60 degrees.
“When your head tilts forward, you’re loading the front of the disks,” says Dr. Kenneth Hansraj, study author, and chief of spine surgery at New York Spine Surgery & Rehabilitation Medicine. Though the study didn’t look at the long-term effects of this position, Hansraj says that, after seeing approximately 30,000 spinal surgery patients, he’s witnessed “the way the neck falls apart.”
He explains, “When you’re eccentrically loading the spine, you’re going to get cracks in the disks, slipped disks, or herniated disks. This leads to stenosis or blockage of the spine.”
In addition, Fishman says, text-neck posture can lead to pinched nerves, arthritis, bone spurs, and muscular deformations. “The head and shoulder blades act like a seesaw. When the head goes forward, the shoulder blades will flare out … and the muscles start to change over time.”
Much like tennis elbow doesn’t occur only in people who play tennis, text neck isn’t exclusive to people who compulsively send text messages. Hansraj says people in high-risk careers include dentists, architects, and welders, whose heavy helmets make them especially vulnerable. He adds that many daily activities involve tilting the head down, but they differ in intensity and propensity for mobile-device use.
I’ve noticed many adolescents slumped over their phones sitting in the passenger seat of their parent’s cars….there will be a whole range of physical and emotional problems resulting from this behavior; believe these printed words! See you in the future!
“Washing dishes is something nobody enjoys, so you do it quickly. And while your head is forward, it’s probably tilted at 30 or 40 degrees,” he says. People tend to change position periodically while reading a book and glance up frequently while holding an infant. But mobile devices are typically held with the neck flexed forward at 60 degrees or greater, and many users, particularly teens, use them compulsively. The study reports that people spend an average of two to four hours a day with their heads tilted at a sharp angle over their smartphones, amounting to 700 to 1,400 hours a year.
To remedy the problem, Hansraj has a simple message: “Keep your head up.” While texting or scrolling, people should raise their mobile devices closer to their line of sight. The Text Neck Institute has developed the Text Neck Indicator, an interactive app that alerts users when their smartphones are held at an angle that puts them at risk for text neck ($2.99, available for Android; in development for iPhone).
Fishman also recommends that people take frequent breaks while using their mobile devices and do exercises that strengthen muscles behind the neck and between the shoulder blades to increase endurance for holding the device properly.
He adds, “I’m an avid technology user — and I use it in the proper posture.”
If you’re not mindful of your body alignment, engaging with mobile devices for long periods can wreak havoc on your spine. This behavior can result in muscle strain, a straightening of the normal curvature of the cervical spine, disk compression, slipped disks, pinched nerves, and arthritis. Here are some exercises that can help prevent and relieve “text neck”:
Increasing the range of motion in the neck keeps the cervical spine flexible and helps maintain its normal curvature. Gentle stretches relieve neck tension as well as lengthen muscles that may have shortened due to chronic poor posture.
Expanding the chest muscles helps to counteract slumped posture.
Strong muscles in the back of the neck and between the shoulder blades will support proper posture, preventing muscle strain and spinal degeneration. With more strength, you will be able to comfortably hold your mobile device in your line of sight without having to bend your neck forward and hunch over. Here are two exercises that help strengthen these postural support muscles:
If you’ve ever made snow angels, you can use a similar movement to strengthen your shoulder muscles while standing against a wall.
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The information herein on "Text Neck Syndrome and Chiropractic Care" is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional.
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