Original Editor - Vidhu Sindwani
What is Text Neck?
"Text neck" is a term that has been coined to describe the posture formed by leaning forward for prolonged periods, for example when viewing a cellphone while reading and texting, reported to cause stress injuries. This posture often results in cervical and shoulder pain, headaches and thoracic hyperkyphosis.
- This condition is a growing lifestyle and health condition with the constant growth in mobile user population all over the world. See also Forward Head Posture
It is a cause for increasing concern especially with children given their greater propensity to mobile phone usage.
- In 2020, the number of smartphone users worldwide projected to reach 3.5 billion.
- In 2020 India had 374.8 million smartphone users. Most of the young adults spend an average of 3 to 4 hours daily.
- Recent figures have shown that around 87% of teenagers (14-18 years) in USA and 79% teenagers (12-15 years) in UK own and use smartphones.
- Among adults aged 18-34 years, 92% and 95% reported owing a smartphone in USA and Australia, respectively.
- Scientific studies don’t appear in a vacuum; they are part of a growing body of evidence. To simply report on a single study is misleading.
- Further trials and longitudinal research is needed to establish association between texting and neck pain and guidelines for use.
Symptoms of Text Neck
Flexing the head forward to use a smartphone directly affects the spine.
- Tilting the head forward to 15 degrees places about 27 pounds of force on the neck.
- This increases to 40 pounds at 30 degrees, 49 pounds at 45 degrees and 60 pounds at 60 degrees.
Damage caused by untreated text neck can be similar to occupational overuse syndrome or repetitive stress/strain injury.
The most common presentation of Text Neck is neck pain, stiffness and soreness. The main symptoms include:
- Stiff neck: soreness and difficulty in moving the neck is usually present when trying to move the neck after long usages
- Pain: can be localized to one spot or may be diffused over an area, usually lower part of the neck. Can be described as dull aching or can also be sharp or stabbing in extreme cases
- Radiating pain: there can often be radiation of pain into the shoulders and arms.
- Muscular weakness: shoulders muscles namely, trapezius, rhomboids and shoulder external rotators are often weak
- Headache: sub-occipital muscle tightness can lead to tension type headaches.
In addition to these common symptoms there can also be:
- Flattening of thoracic kyphosis
- Early onset arthritis
- Spinal degeneration
- Disc compression
- Muscle weakness
- Loss of lung capacity
Prevention is the key when it comes to Text Neck. The following recommendations from a systematic review of Text Neck should be kept in mind while using smartphones or other hand held devices:
- Avoid excessive usage and take frequent breaks
- Avoid prolonged static postures
- Position the device such that it reduces stresses both on the head/neck and the upper extremities
- Avoid high repetitions of movements such as prolonged typing or swiping
- Avoid holding large or heavy devices in one hand for long duration
Rehabilitation is found to be very effective in treating the stress injury resulting from Text Neck. Rehabilitation can be designed as a 2-4 week program starting with soft tissue mobilization, Grade 1 and 2 joint mobilization, active and passive stretches of tight muscles and progressing to muscle strengthening, posture retraining and home exercise program.
In acute cases, pain relief is the main goal. It can be achieved by:
- Regular neck movements: rotations and side bending
- Restoring function to upper trapezius and serratus
- Chin tuck exercises
- Ice/heat packs
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