Text Neck: A Modern Epidemic

Text Neck: A Modern Epidemic

The frequent forward flexion causes changes in the cervical spine, curve, supporting ligaments, tendons, and musculature, as well as the bony segments, commonly causing postural change

Sada (name changed), a 18 year old student came in to my clinic complaining of severe neck and upper back pain. On asking medical history she admits that she spends 14 hours with her mobile in texting and playing games. I told her, I believe the pain is due to the hours she was spending hunched over his cell phone with a diagnosis of Text neck. In today’s world, where the technology has advanced so much, there are more and more people who are spending an increased amount of time on handheld devices such as smart phones, computer tablets and e readers. The end result of prolonged bending of neck results in a TEXT NECK. ‘

Text Neck’ is certainly a new medical term, the condition is impacting millions and is a growing critical global concern. Of the 6 billion people in the world, over 4 billion have mobile phones. Texting has become the dominant form of communication. Over one billion text messages are sent every month worldwide. On the Average, a person spend 2.7 hours per day communicating and socializing on their phones, and even more time looking down at their mobile devices for web searching and so many other uses. It is especially concerning because young, growing children could possibly cause permanent damage to their cervical spines that could lead to lifelong neck pain.


The term TEXT NECK was coined by Dr Dean L. Fishman, who is a US chiropractor. The term Text Neck is used to describe a repetitive stress injury or an overuse syndrome where a person has his/her head hung or flexed looking at his/her mobile or other electronic devices for prolonged periods of time. The average human head is around 10pounds(4.5KG).Imagine putting a 10 pound bowling ball on a stick and then slowly leaning it forward. The stick could probably handle the pressure of holding the ball while it was upright, but as you lean it forward, the stick would start to bend and then eventually it would crack. You might be able to identify the look of “text neck” when you see someone looking downward at his/her phone with the head protruding forward and tilted downward. Depending on the degree of flexion, this action can apply 20-60 pounds of pressure to the neck and supporting structures.  This movement added to repetitive movements, aging, and sedentary lifestyles, leads to the postural muscles that support our spine to become weakened.  

The frequent forward flexion causes changes in the cervical spine, curve, supporting ligaments, tendons, and musculature, as well as the bony segments, commonly causing postural change. Among the chief complaints associated with Text Neck are pain felt in the neck, shoulder, back, arm, fingers, hands, wrists and elbows, as well as headaches and numbness and tingling of the upper extremities.

If left untreated, Text Neck can result in serious permanent damage including: 

Flattening of the Spinal Curve, Onset of Early Arthritis Spinal Degeneration, Spinal Misalignment, Disc Herniation Disc Compression, Muscle     Damage, Nerve Damage.


 Ways to prevent “Text Neck” 

1 – Identify the Cause: 

Do you or your children find yourself being your own pain in the neck?? Any activity that moves the head forward and downward increases the load on the neck area 20-60 pounds.

2 – Awareness of Symptoms:

Realizing when you are moving the head forward and downward is the first step in preventing it. Symptoms include tingling in the fingers, weak grasping ability, shoulder and neck pain, muscle stiffness in the neck, upper and low back, headache, and more. . .

3 – Strengthen Supporting Muscles:

You or someone you know might be experiencing text neck. Strengthening the postural back and neck muscles is an important step in alleviating pain by bringing the head back to neutral alignment. Read more . .

4 – Adjust Reading Material to Eye Level:

Bringing reading material like books, tablets, and phones up towards eye level allows the head to maintain balance on the spine and eliminate pressure onto one specific area in the neck. Another great time to adjust your neck posture is in the car when driving.  Rest your head against the head rest and adjust the mirror slightly higher to create a need to sit tall and keep you head in alignment with the spine.

5 –  Wear your corrective lenses:

Thrusting the head forward to see rather than wearing corrective lenses (glasses)  increases the likeliness of straining ligaments that hold the neck in alignment.  Take the time to get the correct lenses for reading and looking at computer screens etc.

Lifestyle Changes to Alleviate "Text Neck"

There are some simple lifestyle changes which greatly help in alleviating the muscular pain and discomfort of the "text neck" before the condition worsens. A person can make some simple changes in his/her daily posture and lifestyle to make him/her feel better.

o Taking frequent breaks helps in relieving the stress on the neck and shoulders. As a "text neck" is a repetitive stress injury, it can be easily relieved or prevented by taking frequent breaks from the mobile device, like every 20 minutes or so. You should constantly look up and bring the neck back into its original neutral position.

o Other alternative is to hold the mobile/electronic device higher, so that it is in alignment with the eyes and the stress on the neck muscles is reduced.

Treatment for "Text Neck"

If you do not find relief with the above measures for problems related to text neck, then medical attention should be sought immediately.A complete medical examination will be conducted along with other investigations if necessary to find out if there is anything wrong with the neck. Medications, such as NSAIDs and muscle relaxants can be prescribed for symptomatic relief. Heat therapy also helps in reducing the stiffness, pain and soreness of the neck. Gentle massage also helps in alleviating the pain and stiffness of the neck. In some cases, there may be severe degeneration, which causes nerve compression in the neck resulting in "nerve pain." Further investigations need to be done in combination with   pain management.

The author is consulting anesthetist & pain specialist