What is “text neck” and why you should not be worried

In today’s day and age, screens and smartphones are a necessary part of our daily lives. Concerns about the impact of this technology on our health have surged - among these worries is a “diagnosis” known as text neck.

The bent-over posture of the head on the neck allows for easier reading and texting on a smartphone is “related to the increased prevalence of neck pain and other physical symptoms.”[1,2].

Some have gone as far as asking if text neck and smartphone usage is worthy of being seen as an epidemic[3]. 

Is “text neck” truly the epidemic that it’s claimed to be?

The answer is no.

As evidence suggests, this potential “epidemic” is not as prevalent/straightforward as many make it seem.

There is evidence that suggests that:

• Posture and time spent using a smartphone are not correlated with neck pain and disability in young adults [4,5].

• Beyond smartphone use in itself, investigations have continued on the the alignment of the neck - finding that neck alignment has some impact on the progression of certain physical changes in the neck with aging.

• However, there is NO CORRELATION with this and the development of future clinical symptoms [6,7]. 

In addition, “good” posture in the neck, is hard to define and does NOT account for the complexities of pain itself or the variability of the human species.

A research paper by Slater et al.[8] opens our eyes to a more realistic and current view of posture:

1. There is no single “correct” posture. Despite common beliefs around posture, there is no “perfect” posture. AND no evidence supporting that “poor” posture = pain.

2. Differences in postures are a fact of life. Natural variations are normal from person to person in how the spine curves. Not one is “right” so we can’t attribute pain to these differences.

3. Posture reflects beliefs and mood. Beyond physical variations, posture also reflects person’s mental state - emotions, thoughts, and body image. Some postures are adopted as a protective strategy or based on an outside event affecting your mental health, and understanding this is useful beyond just considering pain. 

4. It is safe to adopt more comfortable postures. Comfortable positions vary in every human. Exploring different postures, regardless of appearance or avoidance can provide relief.

5. The spine is robust and can be trusted. The spine is strong and adaptable! It is capable of safely moving and loading in a variety of postures. Common warnings to protect the spine more likely lead to a fear of movement and are therefore not necessary. 

What is the solution if “text neck” is not a thing?

It is vital to acknowledge the forces at play surrounding your neck, but saying “poor posture” leads to the “text neck epidemic” does not account for the full picture - especially since science says the exact opposite.

Text neck is an unsupported claim that spreads a harmful message to the general population. 

Instead of looking for “perfect posture” remember your best posture is your next posture and that long-term spinal health is supported by variable and unique movements.

The goal shouldn’t be to sustain one position for a long period of time, you need to keep yourself moving.

If you’re limited in mobility and strength to access these positions then this is where physical therapy can play a huge role.

Are you interested in working with physical therapists who are experts in movement, mobility, and performance?

Our team can help you get back to doing what you love, you can schedule your evaluation here.

Citations:

1. Arslan, A., & Tutgun Ünal A. Examination of cell phone usage habits and purposes of education faculty students. International Journal of Human Sciences 2013;10:182–201. 5. 

2. Korpinen LH, Pa RJ. Self-report of physical symptoms associated with using mobile phones and other electrical devices. Bioelectromagnetics 2009;30:431–7.

3. Cuéllar JM, Lanman TH. "Text neck": an epidemic of the modern era of cell phones?. Spine J. 2017;17(6):901-902. doi:10.1016/j.spinee.2017.03.009

4. Bertozzi L, Negrini S, Agosto D, et al. Posture and time spent using a smartphone are not correlated with neck pain and disability in young adults: A cross-sectional study. J Bodyw Mov Ther. 2021;26:220-226. doi:10.1016/j.jbmt.2020.09.006

5. Correia IMT, Ferreira AS, Fernandez J, Reis FJJ, Nogueira LAC, Meziat-Filho N. Association Between Text Neck and Neck Pain in Adults. Spine (Phila Pa 1976). 2021;46(9):571-578. doi:10.1097/BRS.0000000000003854

6. Okada E, Matsumoto M, Ichihara D, et al. Does the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteers. Eur Spine J. 2009;18(11):1644-1651. doi:10.1007/s00586-009-1095-5

7. Christensen ST, Hartvigsen J. Spinal curves and health: a systematic critical review of the epidemiological literature dealing with associations between sagittal spinal curves and health. J Manipulative Physiol Ther. 2008;31(9):690-714. doi:10.1016/j.jmpt.2008.10.004

8. Slater D, Korakakis V, O'Sullivan P, Nolan D, O'Sullivan K. "Sit Up Straight": Time to Re-evaluate. J Orthop Sports Phys Ther. 2019;49(8):562-564. doi:10.2519/jospt.2019.0610