Text Neck: The pain of technology

Mobile users frequently adopt prolonged forward head posture while looking down at the screens of mobile devices leading to text neck, which is a postural disorder, a disease of the modern age, that is causing special concern as it is seen in an increasingly younger population.

Walk down a busy city street and try to find someone that makes eye contact; you are more likely to literally run into somebody walking towards you so engrossed in their smart phone world that their walking is slow, automatic and inattentive. This applies to people of all ages. The social implication of this epidemic is altogether another topic, but of concern in the modern era is the potential musculoskeletal consequence of this behaviour.

Our contemporary lifestyle is dominated by technology, with overuse of digital devices and addiction to handheld mobile technology to communicate with others. This induces a peculiar problem –Text Neck – seemingly a worldwide health problem today.
Text neck is a postural disorder, a disease of the modern age, that is causing special concern as it is seen in an increasingly younger population. With increase in mobile device capabilities, we rely on them more and more to perform a variety of tasks. We often text with our head down and chin poking out. Text neck can be described as a repeated stress injury and pain sustained from excessive viewing or texting on handheld devices such as smart phones for long periods of time. Text neck may cause many harmful symptoms such as neck pain, upper back pain, chronic headaches and altered curvature of the spine.
Mobile users frequently adopt prolonged forward head posture while looking down at the screens of mobile devices. Text neck directly affects the spine as it flexes the head at varying angles – when the head tilts forward at 15 degrees, the forces on the neck surge to 27 pounds, at 30 degrees it is 40 pounds, at 45 degrees it is 49 pounds, and at 60 degrees it is 60 pounds, and at 90 degrees it is game over. This issue is a major concern with children since, their heads are larger in relation to their body size than adults, and thus they are at increased risk for text neck, given their propensity to use mobile phones constantly these days.
Early wear and tear in the spine.
Straightening of the spine's natural curve.
Chronic neck and back pain.
Muscle tightness and weakness.
Upper cross syndrome.
Eye strain.
Make an effort to stay in neutral position so that your ears are aligned with your shoulders.
Simply hold your phone or tablet high up in front of your face while keeping your back straight.
If you look down at your device, do it just with your eyes tilted down but keeping your head straight.
Avoid spending hours each day hunched over computers and phones and remember to take frequent breaks and physically relax the neck muscles.
A good physiotherapist will usually focus on getting rid of any muscular imbalances, stiffness, muscular tightness, inflammation and relieving the compression. He will try various soft tissue manipulation, joint mobilization and strengthening techniques. They include:
Myo-fascial release of neck muscles including sub occipitals musculature.
Strengthening of deep neck flexors by chin tucks.
Maintain an optimal length of muscles around the neck, by stretching of muscles such as Upper trapezius, Sternocleiodomastoid, levator scapulae, Scalenes, pectoralis minor, etc.
Helping you performmobility exercises such as looking towards ceiling and down a few times and looking towards your shoulder tip while maintaining normal curvature of cervical spine and trying to touch your ear lobule with your shoulder on the same side. Setting you exercises for strengthening of scapula stabilizers, rhomboids, middle and lower trapezius and shoulder external rotators.
These are some basic exercises which are helpful if your condition is not relieved by this please consult a Physiotherapist for evaluation and treatment.
There are also some home remedies for treating this problem that you can get onto right away. Resting is the first step to allow any injury to heal, and it is no different in this case. Ensure that you give your body enough time naturally to decrease the inflammation and promote the healing process. Any exercise or activity such as use of the mobile device that aggravates the neck, or replicates the symptoms, should be stopped immediately. Remember that this is an initial measure, and it is important to remain otherwise active to ensure the muscles of the neck do not become too stiff.
Second, if you head to a professional, a trained therapist who can massage and manipulate the correct neck muscles, not only does this provide pain relief, it is critical to the rehabilitation. Decreasing the tightness in the muscles, and realigning your neck, can almost instantly reduce your stiffness.
Third, you need to implement an exercise program to help your pain and rehab appropriately. Exercising will help to reduce the stiffness that you feel, and will ensure that any manipulation you had is maintained. A strong neck is a healthy one. Range of motion exercises are often necessary at the beginning. Stretching exercises, isometric, and other low impact neck strengthening exercises can be implemented.
Hot Cold Therapy: This is another home remedy and very simple to do. Alternating between hot and cold packs on the affected area can help to reduce the pain, the inflammation and many other symptoms that are present. 20 minutes is a good time to work by, and you can get packs that you can heat and cool.
Lastly, if the symptoms and the pain is severe, then medications become necessary. As much as you love to decrease your pain naturally, often it is important in neck treatment to use some form of pain and inflammation medication. Anti inflammatory medicines can help to reduce the pain significantly. Sometimes, dry needle therapy or injections can be helpful, but these are last-ditch measures.
Although it now seems rather clear that repetitive texting, or similar activity while using a forward flexed neck position, may lead to neck pain or text neck, what is currently unknown is whether this poses a risk for intervertebral disc degeneration and consequent cervical spondylosis. Perhaps of even greater concern is the potential risk to the developing spine, considering the young age at which cell phones use by children now commonly starts.
The most common cause of this painful condition called Text neck is poor posture. Few other factors that contribute to this type of pain are: poor sleeping habits, poor sitting habits, cold drafts, stress, etc. The overload in muscle tension just to hold your head up in this way, can eventually lead to permanent eye strain, chronic headaches and migraine. You can avoid stiff neck, upper back ache and even headaches and migraine by being well aware of your posture. The 20-20-20 rule which means every 20 minutes take a 20 second break and focus the eyes on something at least 20 feet away is recommended to practice in order to avoid musculoskeletal problems related to text neck. The correct posture to prevent text neck syndrome is the ears be aligned with the shoulders and the shoulder blades, retracted so this proper bodily alignment diminishes spinal stress.
Most important of all, don't slouch while using mobile devices. Sustained correction of slouched posture also depends on reminding oneself to straighten the mid-back and lift the chest and head throughout the day. This also applies to sitting, where slouching seems almost automatic. Sit straight on the butt, not on the lower back, and maintain the lumbar curve by sitting back in a chair with a lumbar support. Keep the chest and head held high. And learning to stand straight can also be a challenge. You finally understand that you had always been leaning forward when you find it feels unnatural to stand straight against a wall—with butt, shoulders/upper back, head touching the wall and knees slightly bent. If the back of the head doesn't touch, do not force and do not tilt it back; but straighten excessive curve of the upper back, if it is still flexible, with a deep breath, which will bring the head back, and fix the shoulder blades in the proper posture with the correct movements. The longer good posture is maintained, the more natural it feels and the stronger become the postural stabilising muscles. Maintaining good posture is difficult; but doing it strengthens postural stabilising muscles (the Core), which in itself is legitimate exercise.

(Dr Ravees Raja (PT).MPT, DRT, CKT, CDNT is a trained physiotherapist and rehabilitation therapist. You can contact him at

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