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Global Health Population Series ::: October 2024


Why Your Smartphone May Be Ruining Your Neck (And What To Do About It)

By Clarance Ezinwa PT


Photo from Non Surgical spinal care. 


What do you notice about these two pictures??



The latter's head is positioned more forward??


Yes. 


Referred to as “text neck”, “poke neck” “phone neck syndrome” or “text neck syndrome (TNS)”; diagnosed by musculoskeletal clinicians after thorough physical and subjective examinations in patients complaining of pain, stiffness and discomfort in their necks commonly due to sustained use of handheld devices. 


6.8 billion people have an active cell phone, that’s about 8 in every 10 people!!


These days there are apps for everything, which could translate to more time people would spend being stationary, either poking their head awkwardly watching TV, or neck leaning forward towards their smartphone; both could significantly increase the pressure put on the neck over time. 



So, what is this text neck syndrome?? 




Also called TNS, is a deviation from good neck posture. Good neck posture is when the ears are aligned with the middle of the shoulders


TNS is an overuse injury (occurring when tissue is damaged due to repetitive demand over a period of time) that happens at the neck which could cause  the neck bones to break down overtime due to the unnatural positioning of the head for a long period of time. 


This causes the weight load on the neck to increase as much as six times compared to the normal posture/alignment of the head. 



What could cause TNS


According to an article published on National Library of Medicine, TNS could happen in two ways: 


  1. Bending your neck (as in when looking down at a cellphone)

  2. Bending your lower neck while keeping the upper neck level straight (as in when looking at a computer screen in front of you) 


Studies show that the average forward leaning angle of your neck while texting to be 37- 47 degrees; your head weight could increase to 18.14 kg at 30 degrees and 22.3 kg at 45 degrees!! 


Forward leaning of the neck for a longer period of time could have several musculoskeletal effects including;


  • Inflammation of the soft tissues of the neck

  • Change to the normal curvature of the spine.


So, avid book readers, professional piano players, full time academic clinicians and researchers, typists, receptionists and a lot of similar desk professions could very much be at risk of coming to the clinic with complaints of headache, pains, spasm and tightness in their neck due to similar activities. 


It could also be as a result of lifting weight improperly. The neck consists of very delicate structures, so it’s always advisable you avoid repeated movements  that excessively include the neck, causing strain injuries. 


Text neck affects the joint and ligaments of the cervical spine which leads to an increased gravitational force on the posterior neck musculature!!


It’s why it’s always advisable to adapt proper form while lifting heavy to avoid permanent damage to soft tissues that stabilize your joints. 














What could suggest you have TNS??





  1. The most obvious symptom is general neck pain which could be intermittent or persistent, felt during movement, localized or diffused over the area, usually affecting the lower part of the neck. Pain could be radiating to the upper shoulder or arm.


  1. Frequent neck stiffness, spasm and tightness. It sometimes could come with pain, muscle weakness and numbness also occurring in shoulder muscles (trapezoids, rheumatoid). 


  1. Intermittent and/or constant headache with origins tracing back to the neck. 


  1. Early onset of arthritis. 


It’s always important to see a qualified physiotherapist, chiropractor for evidence based diagnosis and care of your symptoms. 




What are the usual Complications associated with TNS



Though there aren’t enough research to support the long term effects of TNS, it’s still known among many experienced clinicians that prolonged TNS could lead to a lot of postural complications when left unchecked for a long time


Some of this complications includes:


  • Forward head posture (FHP)

  • Dowager’s hump ( protrusion of the bone on top of the back)

  • Oddly Rounded shoulders

  • Chronic cervicogenic headache 

  • Disc compression

  • Upper back muscles pain

  • Breathing problems 

  • Reduced kinaesthesia 

  • Increased stress levels



What Your Physiotherapist Would Do About Your TNS


Proper neck and body posture while at your workplace, and/or handling devices correctly remains the best remedy to prevent TNS.


Early noticing and reporting to your nearest specialist could go a long way in prompt management of TNS. The problem is that not many people know what to look out for when it comes to symptoms concerning their neck.


Rehabilitation of TNS can be designed as a 2-4 weeks program with TNS often resolving after 4-6 weeks 


It starts with some soft tissue mobilization, active and passive stretches of tight muscles and progressing to muscle strengthening, posture retraining and home exercise program.  


In acute cases, pain reduction is always prioritized and this is subsequently achieved by 


  • Neck range of motion exercises; minimal- moderate rotations and side movement to reduce the discomfort that could come from stiffness.

  • Gentle massage to reduce tension and spasm. 

  • Ice/Heat packs to modulate pain and inflammation. 

  • Neck stretches 


Patients are also advised to avoid aggravating factors which may include reduced screen time while learning improved posture while using devices. 


In extreme chronic cases, 


-Injections of pain medication into the facet joint are used when pain is unbearable

-Acupuncture are registered in relation of pressure points along the neckline

-Postural braces are prescribed depending on severity

-Postural taping techniques. 


Advice and proper education regarding preventing and managing this condition.


Surgery is not always the answer 


But only suggested when painful disc herniation is present, or in cases where there is nerve impingement. 




Tips for better care of your natural spinal curvature


  1. Avoid sleeping on your back without using pillows to support your cervical and lumbar spine as it places undue stress on your spine's natural curvature, rather sleep on your side.


  1. Proper back care while sitting, lifting, running is always emphasized as it removes undue pressure on the back in the later in life. 


  1. Sit with your back against a suitable backrest, head on headrest, your both feet firmly on the ground with your thighs horizontal at your hip level. 


  1. Adjust your work monitor/TV to your eyes level so you don’t poke your head unnecessarily. 


  1. Avoid prolonged static positions. Stand up at intervals. While at it, make sure to maintain an impressive upright posture with your weight transferred evenly across both feet. 


  1. While using a mobile phone, ensure you raise it to your eye comfort level. Don’t bend your neck 


  1. Avoid checking your phone while walking as much as you can. Stop when you want to use your phone and raise it to your eye level









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