Text Neck Overuse Syndrome

Neck pain is becoming all too common, and we are spending longer and longer on our mobile phones; 3.5hrs a day on average. One study showed texting causes the worst strain on the neck from the severe degree of neck flexion, especially when sitting, perhaps because of the accuracy required to key correctly. This ”text neck” is a global phenomenon.

Text neck, Smartphone neck, and iPhone neck are alternative names to describe the posture problems or neck pain from prolonged smartphone use. These terms also apply to tablets, games, laptops or other handheld electronic devices.

Postural Strain and Neck Pressure with Text Neck

Using a mobile device often can lead to poor posture and symptoms of text neck. We often need to hold the phone with both hands, creating tension in our arms, shoulders and neck. Unlike reading, because of the small screen we look down more, with increased neck flexion. We can all tend to get stuck in these bad positions for a much longer time than we expect.

Pressure on the neck with increased flexion

We’ve been looking down for many centuries with activities like reading books, drawing, sewing, and crafts. Text neck, however, is different; it is the extreme neck flexion looking down with tension that is the problem. Even if we’re working in an office, we must adjust the monitor to the right height (see Screen and Monitor Height for optimal neck and eye health).

Our head weighs about 4.5-5kg. If the spine is healthy, we’re not aware of its weight and we can move our heads freely. As we tilt our heads forward, the pressure on our spine hugely increases. It’s estimated for every inch we tilt our heads forward, the stress on the cervical spine doubles – up to 60lbs. Imagine you could do this for about 3.5hrs a day on the phone alone, and stress on the neck quickly adds up!  

Symptoms of Text Neck  

Poor postural development in children 

Worst of all it’s happening in children whose spines are still growing. This can create more long-term postural changes to their cervical spines. Spines tend to form during our growth period up to about the age of 17, so for young teenagers the poor postural changes can then last a lifetime… 

Neck and upper back pain

Neck and upper back pain is the most common complaint: either a dull ache or sharp muscle spasm, which can lead to worsening chronic neck pain and further arthritis in the neck.


Eye problems

The short wave blue light emitted by smartphones tire eyes very quickly. It may even cause corneal damage, harming your vision. it’s best to limit your time with blue-light digital devices and take breaks often to rest the eyes. Night settings on phones now address this issue somewhat. More information about eyes and screens can be found here.

Trigger Thumb 

Holding the thumb tense for a long time by texting can cause it to get stuck in a bent position, which then pops when you try to straighten it.  The tendon sheath surrounding your thumb tendon can become inflamed and thicken, giving pain and preventing free thumb movement. 

Thumb Arthritis 

Thumb arthritis can clearly be aggravated (if not caused) by overuse. The cartilage wears away from the ends of the bones that form the joint at the base of your thumb. It can cause severe pain, swelling, weakness and loss of movement, making even simple tasks, like turning doorknobs and gripping objects, painful. Eventually the joint can enlarge at the base of your thumb. 

Cubital Tunnel Syndrome 

Leaning on the elbows to text or bending them whilst talking on the phone can irritate the ulnar nerve at your elbow, the ‘funny bone nerve’, which causes weakness, numbness, tingling and soreness down the forearm to the 4th and 5th fingers. Try to break the habit of slumping or leaning heavily on the elbows, and avoid over-bending the elbows, especially at night. 

Repetitive strain injury to the fingers & forearms 

Matthew Bennett from the British Chiropractic Association (BCA) recognised, as far back as 2006, that texting could cause repetitive strain which may cause both short- and long-term injuries. The issue is, when text messaging, we need to hold the phone often with two hands and it’s all too common we keep the shoulders and upper arms tense, which cuts down the circulation to the forearm, when in fact more blood flow is required to help the constant movements of the fingers and thumbs. 

Nerve & arterial irritation from the neck or shoulder girdle 

With repetitive strains and prolonged tension in the shoulders, arms and neck, the muscles at the base of the neck can begin to spasm and tighten, and can press on either the nerve or the blood vessels down the arm. This can give transitory pain, burning or numbness down the arm to the fingers. Please read more about this in the full article on Thoracic Outlet Syndrome.

Stress headaches 

Because it’s a small device, the head is bent forward locked in one position without moving for long periods of time. With the lack of movement, the stress on the muscles causes fatigue and spasm with reduced blood flow, especially to the muscles at the base of the skull and can lead to headaches. 

Sleep deprivation 

Reduced melatonin production can occur with spending time on the phone, making it harder for you to fall or stay asleep. 

Walking into a lamppost whilst texting! 

I include this because how many of us have done this, or nearly done it (even if we won’t admit it)? Not looking where we are going can cause injury, not just the embarrassment and stick from your friends! Perhaps we need to slow down and look where we are going? 

On a serious note, texting is distracting and injuries occur when we are not concentrating. 

How to Prevent Symptoms of Text Neck  

  • Try to learn to relax your shoulders whilst texting. This will help the whole arm to relax. 
  • Slow down, don’t text too fast; learn not to tense the fingers. 
  • Stop and take breaks, especially If texting starts to become painful. 
  • Learn to text using both hands, switching regularly. 
  • Vary the fingers you use. 
  • Don’t text for more than a few minutes without a break. 
  • Learn how to effectively use voice recognition, Siri, Alexa, or google assistant. 
  • Type text messages on the computer via messaging software. 
  • Have a facetime or video chat, or consider the good old fashioned voice call! 
  • Use a headset so you don’t hold the phone for calls or dictation. 
  • Careful looking down too long at your phone surreptitiously hidden under the desk in a classroom or meeting. 
  • Raise your viewing angle by putting the phone on a stand. Even bringing the phone up 6″ and tilting the phone can hugely reduce the neck flexion and strain. 

Chiropractic treatment can clearly help with acute pains of text neck, but please try to heed any warning signs, change your habits and prevent it getting worse or becoming long term and chronic. 

Other Health Risks of Smartphone Use

  • Smartphones have germs – clean them regularly 
  • Texting and driving increases your risk of crashing by up to 23 times! 
  • Talking and driving increases that risk by 4 times. 
  • Night use can cause sleep disturbance; blue light from smartphones is especially bad. 
  • Is there a cancer risk? Cellphone radiation is a suspected link. Try to use speaker mode or a headset. 
  • Beware of smartphone interference with medical devices like pacemakers, implantable defibrillators, or hearing aids. 

Smartphone Screen Time Stats 2019 

Our phones have become modern day safety blankets, and many of us can’t be without them, be it for work or social interaction. That means that most of us are spending too long our phones. Whilst they can be incredibly useful, studies are beginning to show they can have a bad impact on our health and ability to focus our attention. If your phone pings or vibrates frequently it can be very distracting.  I’m sure many of us have played on our phones in a boring meeting and my daughter was put in detention for playing on it in class…

The true impact of our screen time is about: 

  • How long we spend on our devices. 
  • How often we use them. 

Smartphone Statistics (from 11,000 users of RescueTime app) 

  • We spend 3 hours and 15 minutes a day on average on our phones 
  • The top 20% of users have daily screen time in excess of 4.5 hours. 
  • Slightly more time is spent on phones during the week than on weekends.  
  • Most people check their phones 58 times a day (30 times at work). 
  • Most people spend 1 minute and 15 seconds on their phone each time. 
  • 37.5 minutes are lost a day during working hours to our phones (at a minimum). 
  • 70% of screen time sessions are less than 2 minutes in length. 
  • 50% of screen time sessions start within 3 minutes of the previous one. 
  • Psychologists find switching focus (phone distraction) can cost up to 40% of productive time. 
  • Just having your phone around undercuts your ability to do good work. 

Source: The RescueTime blog.