> Neck Pain > How Does Text Neck Cause Pain?
How Does Text Neck Cause Pain?
Text neck refers specificly to a repetitive stress injury or overuse syndrome in the neck, which is typically caused by prolonged use of mobile devices with the head bent downward and not really or particularly moving much for a prolonged time, repeatedly.
- tech neck
- iPhone neck
text neck is usually associated with texting, but it can be related to many activities
performed on phones and tablets while looking downward, such as
- browsing the web
- playing mobile games
- reading comics/news/text
- or doing work
Head’s Weight Magnified
The weight of the head is a key factor for text neck pain.
muscles, tendons, and ligaments are created to support our head’s
weight, which is about 5 kilograms (kg), which translates to about 10 to 12 pounds in a neutral position balanced atop the cervical
However, whenever we use our phones, it is so unfortunately common to bend the head forward
and look down at a 45- or 60-degree angle, which places about 50 to 60
pounds of force on the neck.
Our neck is not able to withstand this amount of pressure over a prolonged period - it's not made for that.
Our heads are meant to rest/sit on our shoulders, and the poor posture really strains our neck muscles terribly.
If not treated with spinal physiotherapy and phone postures corrected, next neck and neck pain may become worse.
Related Article: How Poor Posture Causes Neck Pain
how text neck develops and progresses
Text neck typically starts as a relatively "safe" mild ache in the neck or
upper back. In some cases, it could also start with/as sharp pain or stiffness in the
When text neck is suspected of causing pain, it is typically
treated with a combination of:
If your neck pain or text neck is not treated or improved, the continued forward head posture and hunched
shoulders will worsen over time, which will lead to even more pain and
reduced mobility in the neck, upper back, and shoulders.
In some cases, the excessive anterior forward head posture may exacerbate or
accelerate degenerative conditions in the cervical spine (neck bones), such as
Unique Risks of Smartphones and Tablets to Stress the Neck
Here are some reasons why smartphone and tablet use may pose some unique risks to stress the spine:
- Severe neck angle to view the screen.
TVs and personal computers which tends to be placed at a further (and better viewing angle/distance), smartphone and tablet screens are more
commonly viewed while flat on a table or lap, which means the screen
angle is much more severe.
That's why it causes us to crane and "reach forward" our neck and head to view smartphones than other screens.
- Touchscreen element may bring shoulders and head further forward.
Research in the Ergonomics
journal found that study participants had more forward head posture while
texting compared to other smartphone tasks, such as web browsing or
watching a video.
Maybe because texting may involve the use of both hands as well as increased time with fingers touching/tapping the screen, which possibly recruits the muscles of the forearm, arms, shoulders that "pull" forward during use (especially when engrossed).
Yes, there are some other activities, such as reading a printed paper book or washing
dishes, which also triggers and prompt people to forward tilt their heads, but the difference may
be that people use smartphones and tablets for a much longer time and
are less likely to shift positions.
(We don't typically wash dishes that long, and also washing dishes require us to move about...unless one works as a washerperson who washes dishes 6-10 hours a day)
Impact on Growing Spines Still Being Studied
There is especially special concern about the potential health impact on
teenagers— who are among the most frequent text message users—whose spines are
Many doctors, spinal physiotherapists, chiropractors, and other medical
professionals have reported seeing an increase in neck pain and poor
posture among teenage patients due to frequent texting and mobile device
use, even in our Phoenix physio clinics.
Yes, while we recognize and realize that holding the head forward for long periods of time is a risk factor for neck pain,
there is some debate as to how much of a factor smartphone and tablet
use plays in neck pain and poor posture in teens and young adults.
a study of young adults in Sweden found a link between texting time and
neck pain, the results appeared stronger in the short-term rather than
That being said, there was a study in Brazil that studied 18- to 21-year-olds that did not find a correlation between texting and neck pain.
We definitely need a lot more research to accurately pinpoint and determine the long-term impact that texting and mobile device use might have on neck health.
Text Neck Symptoms and Diagnosis
Text neck is not an official medical diagnosis (and jokingly also called iNeck or iPhone neck), but rather a term
commonly used for a repetitive stress injury where excessive texting or
mobile device use is believed to be the primary cause.
A doctor and our senior spinal physiotherapists typically identifies patients text neck pain after a
physical exam and patient history are taken, including reviewing the
Common Symptoms Associated with Text Neck
ext neck symptoms commonly include one or more of the following:
- Pain in the neck, upper back, and/or shoulder
pain may be limited or localized to one specific spot and may feel intense or stabbing,
or it may be a general ache and soreness that covers a broader
region, such as spanning from the bottom of the neck and into the
Related Article: Neck Pain & Shoulder Pain
- Forward head posture and rounded shoulders
in the neck, chest, and upper back can become overstrained, deconditioned and
imbalanced due to repeated damage from prolonged forward head posture. This particular deconditioning
can make it difficult to maintain good posture with the ears directly
over the shoulders.
- Reduced mobility
The neck, upper back, and shoulders will gradually become tighter, stiffer with overall decrease range of motion and painful at end range movement.
Muscles at the base of the neck can tighten or even go
into spasm and become painful, or pain could also be referred from the
neck up into the head (from myofascial trigger points due to poor posture).
Excessive amounts of time looking at screens,
regardless of posture, may also increase the risk for eyestrain and
- Increased pain when neck flexion.
Text neck symptoms tend to worsen when the neck is flexed forward into
the position that originally caused the problem, such as while looking
down and texting.
Where and how pain is felt can vary from case to case and patient to patient.
As an example,
- a patient who mainly looks at a phone screen while using both hands (or
no hands if it is lying on a table or lap) may be more susceptible to
having pain evenly "balanced pain" distributed on both sides of the neck and/or upper
back, as compared to
- someone who uses one hand may have more pain on one side
due to using or straining those muscles more (one sided pain, or pain more on one side more than the other)
Less Common Symptoms Associated with Text Neck
Some other symptoms where the prolonged forward head tilting of text neck may play a contributing role include:
- Cervical radiculopathy
Symptoms of electric
shock-like pain, pins-and-needles tingling, numbness, and/or weakness
may radiate from the neck down into the shoulder, arm, and/or hand.
Cervical radiculopathy can happen when a cervical nerve root becomes
irritated or compressed, such as from spinal changes related to
degenerative disc disease or osteoarthritis. Severe cases of text neck
may accelerate or worsen this process.
Related Article: Cervical radiculopathy
- Balance issues
Prolonged amounts of time in
forward head posture have been linked to reduced balance control and balance problems, due to
the head’s center of gravity moving unnaturally further in front of the body.
This process will result in muscle imbalances and postural control
changes in the neck and torso.
- Jaw pain
A misalignment in the cervical spine and/or muscle imbalances may lead to jaw pain, or temporomandibular joint (TMJ) pain.
Other symptoms may also be associated with text neck.
Patient History and Physical Examination
When visiting the doctor with a primary complaint of neck pain, typically the first 2 steps involve:
- Patient history
The patient’s medical history,
family health history, exercise and diet habits, medications, as well as
current symptoms (and when they started) are reviewed.
- Physical examination
The neck is observed for any
unusual posture or lesions, and palpated for possible areas of muscle
tightness or tenderness.
The patient's head may also be gently guided through
various ranges of motion to see if specific neck movements are
restricted or alter the pain response (improve, worsen, or no change).
If the patient's neck pain and/or neck stiffness is mainly due to a repetitive
stress injury, such as text neck or tech neck, our senior spinal physiotherapists will do an in-depth assessment so that enough information is
obtained through a careful patient history and physical exam
to make a diagnosis and start spinal physiotherapy treatment.
If more serious causes of neck pain are suspected during the patient
history and physical exam—such as nerve root compression (such as slipped disc and sciatica), fracture, or a
serious underlying medical condition—imaging (x-ray or MRI) and other tests may be
Adjustments to Prevent Text Neck Pain
- Raise your tablet or phone
Bring your phone (and any other mobile or viewing devices) up closer to eye level so that your eyes or head does not have to be tilted forward.
- Take frequent breaks (even short micro-breaks can help)
Try to spend some time away from the
phone—or any type of head-forward posture regularly. If needed, set an alarm or
app to set automatic reminders to take breaks from handheld devices.
- Stand up straight
Good posture, with your chin tucked in and shoulders pulled back, will help to keep and protect the body when it is aligned in a neutral position.
- Arch and stretch
Arch your neck and upper back backward regularly to improve blood flow, improve recovery and even ease any aches and muscle pain.
- Exercise regularly
A strong, flexible back and
neck is 100% more able to handle extra stress and load. Research indicates that
teenagers who are active in low-impact team sports or endurance sports
are less likely to have neck pain.
In general, finding ways to keep the neck and body more active,
rather than hunched over a mobile device, is best for the spine.
Exercises and Stretches to Reduce Neck Pain
With text neck and other conditions related to forward head posture, muscle imbalances usually develop like this:
- The deep cervical flexor muscles at the front of the neck become
overly stretched and elongated while the muscles connected to the head at the back of the
neck become tightened and shortened
- The upper back muscles become elongated while the chest muscles become shortened
Some evidence also suggests that performing exercises and stretches
in a school setting can help improve posture.
There was one specific study that looked at 130
teenagers with forward head and protracted shoulder posture. Half of the
students (65) were enrolled in a physical education class that also
exercises and stretches designed to correct postural muscle imbalances.
After 16 weeks, the students in the class with targeted exercises had
more improvements in both neck and shoulder posture compared to the
As an general guide or rule of thumb, regularly engaging in exercise that teaches
posture and body awareness is an excellent way to counteract the
tendency of developing neck pain from poor posture.
Examples of such
exercise programs include
text neck spinal physiotherapy
Text neck spinal physiotherapy treatments may include:
you find that you have any back or neck pain, be it recently or have
been experiencing it for some time already; or know someone who does, do
consider seeing our specialist spine physiotherapist. You may even
prevent the need for back or neck surgery by early spinal physiotherapy
Do not hesitate or wait for it to go away - pain
is a normal response by our bodies to signal to us that there is some
issues to resolve, and the earlier it's resolved, the faster it'd be
resolved. When/if one delays on it, it may become worsen/progress into
something more serious that may take much more time to resolve.
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