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Text Neck - Is Your Smart Phone Hurting Your Cervical Spine?



If you take a look all around you, you may realize that many if not most of the people may be engrossed using their smartphones. And one thing that we senior physiotherapists treat in our physio clinics is a recently increasing condition called "text neck"

Yes...unfortunately, text neck is a "real" thing.

Using small, hand-held electronic devices typically leads to users spending a lot of time with their head bent forward. We see these at

  • work places
  • people in the trains
  • people in the buses
  • people everywhere, actually.

The problem is—this head action actually hurts your neck.

A simple summary of what leads, causes and aggravates text neck is the forward (anterior) posture of the elongated neck during prolonged use of the neck and head, as typically in the use of mobile devices, causes unnatural and additional damage to the neck muscles that work very very hard to support the neck.

Typically, our head weight "sits and rests" on our shoulders, but when it's elongated forward like in text neck, it causes our neck to be the only muscles supporting the weight of the head, and this strains it unnecessarily.

Regular use of your mobile devices and smartphone may lead to preventable (though treatable by our senior physiotherapists) neck pains and problems.

It's now popularly called "text neck", but there are other names as well, jokingly too called names like

  • iNeck
  • iPhone neck
  • mobile neck
  • etc

Of course, these are not the real medical names or diagnoses - just colloquial names. They are all referring to the same issue of: pain and discomfort that is experienced in the neck, which are posture problems in the cervical spine that are created by prolonged use of a cell phone, tablet or similar handheld electronic device.

“People get so focused on these devices that they end up holding their neck and upper back in abnormal positions for a long period of time; enough that other people coined the phrase ‘text neck,’ which is essentially referring to postural pain,” says Chris Cornett, M.D., orthopaedic surgeon and spine specialist at the University of Nebraska Medical Center Department of Orthopaedic Surgery and Rehabilitation.

Dr. Cornett continues by saying that “When you hold your body in an abnormal position, it can increase stress on the muscles, cause fatigue, muscle spasms, and even stress headaches."

Text Neck Risks

A study by Lee and colleagues published in the October 2014 issue of Ergonomics found that repetitive or prolonged head flexion posture during smartphone use is a risk factor for neck pain.

This study is a very small study, with just 18 participants and studied them as they performed 3 tasks with a smartphone:

  1. Texting
  2. Browsing and 
  3. Watching a video

Participants did these activities in sitting and also in standing.

The study identified a correlation of head flexion associated with heavy smartphone use as a risk factor for neck pain, but it also found that of the 3 activities, texting may be the biggest contributing factor to device use-related neck pain. 

In the study, texting while sitting caused the largest degree of head flexion.

Text Neck Symptoms

Text neck symptoms may include

A 2012 study involving 18 people conducted at Google headquarters in Mountainview, California, looked at (among other things related to tablet use) how much head flexion resulted from checking email and surfing the web. This study also measured head flexion as people watched movies on their tablet while sitting at a table.

The researchers found that participants who used the tablet without a table (i.e. with the device on their laps) had extreme head flexion. The head flexion for movie watchers at tables was less.

How to Avoid or Prevent Text Neck

The best strategy for mitigating the effects of device usage on your neck is to directly raise your mobile/tablet use and viewing angle.

There are a few things to try. You can put the tablet on a stand or on a table (we use a stand to raise up the viewing and using angle). You can use textbooks or boxes, but a simple stand is likely the most convenient one.

We highly do not recommend that you work with it on your lap, but if you really, really, really have to, please consider propping it up with a pillow.

And if you think holding the tablet up with your hands may reduce your head flexion angle, beware. This positioning will likely tighten up the muscles in your forearms, which can cause an entirely different type of discomfort or pain, possibly leading to repetitive strain injuries in the hand such as:

(See more hand and upper limb conditions here)

Dr. Cornett offers common sense approaches to avoiding text neck such as getting and staying physically fit and taking regular breaks from your device (we wrote an article called taking micro-breaks to prevent repetitive strain injury). 

text neck spinal physiotherapy

Our specialist spine senior physiotherapists are trained, passionate, experienced and experts in assessing and treating spine conditions.

One of the most important thing for patients to note is that spine problems can be prevented from occurring or recurring by regular training and keeping the back and core muscles strong but flexible 

Spinal physiotherapy treatments may include:

If 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 intervention.



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Email questions and your preferred physiotherapy timings to nigel@phoenixrehabgroup.com or

WhatsApp / SMS your name, preferred date, time and enquiries to +6588001830

Clinic Locations: See how to get to us here

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All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).

See our entire team here with introductions and their specializations.

At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.

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book your physio appointment or enquire now

Email questions and your preferred physiotherapy timings to nigel@phoenixrehabgroup.com or

WhatsApp / SMS your name, preferred date, time and enquiries to +6588001830

Clinic Locations: See how to get to us here