How Inappropriate Use of Your Phone is Bad For Your Neck (and fingers and eyes) and What You Can Do about it.

You can listen to this article on Spotify.

After you read this article, I promise you that you will change the way that you are using your phone. I am not encouraging you to stop using technology, but this article will educate you on the potential damage and impairment that your phone can cause to your neck, fingers, and eyes. Later in this article, I will introduce you to several ways of minimizing the risks by changing your current habits. 

The vast majority of Americans, (96%!), now own a cellphone of some kind. 81% of Americans own smartphones. Along with mobile phones, Americans own a range of other information devices, such as tablets and iPads, laptops, Kindle, Video game console, and more. Recent figures have shown that around 87% of teenagers (14-18 years) in the USA and 79% of teenagers (12-15 years) in the UK own and use smartphones. According to recent research in the journal of physical therapy that published last year (2019), smartphone users spend an average of two to four hours a day with their heads dropped down. This results in “700 to 1,400 hours a year of excess stress on the cervical spine. High schoolers may be most at risk, as they could spend an additional 5,000 hours per year in this position.

Recently, spine specialists are noticing an increase in patients with neck and upper back pain, likely related to poor posture during prolonged smartphone use. A 2017 scientific paper from The Spine Journal reports an increasing number of young patients, who shouldn't yet have back and neck issues. These patients are reporting disc herniations and alignment problems.

Head’s Weight Magnified

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. So for example, when texting on a phone, it is common to bend the head forward and look down at a 45- or 60-degree angle, which places about 50 to 60 pounds of force on the neck. The neck is not able to withstand this amount of pressure over a prolonged period. Let’s talk about the significance of 60 pounds? Imagine carrying an 8-year-old around your neck several hours per day. 

The ‘Text Neck’

The term “text neck” refers to a repetitive stress injury or overuse syndrome in the neck, caused by prolonged use of mobile devices with the head bent down and not moving. Text neck is commonly associated with texting but can be related to many activities performed on phones and tablets while looking downward, such as surfing the web, playing games, or doing work.

Common Symptoms of Text Neck

Text neck symptoms commonly include one or more of the following:

●       Pain in the neck, upper back, and/or shoulder(s). This pain may be located in one specific spot and feel intense or stabbing, or it may be a general achiness and soreness that covers a broader region, such as spanning from the bottom of the neck and into the shoulder(s).

●       Forward head posture and rounded shoulders. Muscles in the neck, chest, and upper back can become deconditioned and imbalanced due to prolonged forward head posture. This deconditioning can make it difficult to maintain good posture with the ears directly over the shoulders.

●       Reduced mobility. The neck, upper back, and shoulders may all experience some tightness and reduced mobility.

●       Headache. Muscles at the base of the neck could go into spasm and become painful, or pain could also be referred from the neck up into the head. Excessive amounts of time looking at screens, regardless of posture, may also increase the risk for eyestrain and headache.

●       Increased pain with neck flexion. Text neck symptoms tend to worsen when the neck is flexed forward into the position that originally caused the problem, such as while looking down and texting.

In addition to these common symptoms, there can also be: flattening of the normal of thoracic curve, or kyphosis, accelerated degenerative conditions in the cervical spine, such as cervical degenerative disc disease and/or cervical osteoarthritis, disc compression, muscle weakness, and in severe cases loss of lung capacity.

What we can do?

Here are a couple of recommendations for treating and/or preventing neck pain while using smartphones (this also applies to tablets, kindle, and other handheld devices)

●       Raise the phone. Move the phone (and other devices) up closer to eye level so the head does not have to be tilted forward. Position the device such that it reduces stress both on the head/neck and the upper extremities. Try to keep your head and spine in neutral positions with the ears directly above the shoulders throughout the day. For example, hold your phone or tablet up a little higher, closer to eye level to minimize stress on your neck. If you have a desk job, remember basic things such as using a chair that helps your backstay upright, keep your feet flat on the floor, and position your monitor at eye level to avoid looking up or down too much.

●       Avoid excessive usage and take frequent breaks. Try scheduling just a few times per day to check text messages and emails, rather than responding multiple times per hour. Spend some time away from the phone—or any type of head-forward posture. If needed, use an alarm or app to set automatic reminders to take breaks from handheld devices.

●       Stand up straight. Good posture, with the chin, tucked in and shoulders pulled back, keeps the body aligned in a neutral position, and helps improve postural habits when using smartphones and other mobile devices.

●       Arch and stretch. Arch, or extend, the neck and upper back backward occasionally to ease muscle pain. Performing some neck exercises and stretches daily can help treat text neck as well as reduce the risk of painful recurrences. When your neck muscles are strong and flexible, they’re better able to hold good posture and less likely to have a painful spasm.

●       Exercise regularly. A strong, flexible back and neck are more able to handle the extra stress. Some research indicates that teenagers who are active in low-impact team sports or endurance sports are less likely to have neck pain. Exercises and stretches regularly to increase the neck’s strength and flexibility. Keep in mind that muscles in your chest, shoulders, and back play key roles in posture as well. For example, people with a text neck also tend to have tight and weakened chest muscles from hunching over too much. Many of these muscles work together, so it’s a good idea to keep all of them strong and flexible.

●       Avoid prolonged static postures. Static postures (or “static loading”) refer to physical exertion in which the same posture or position is held throughout the exertion. These types of exertions put increased loads or forces on the muscles and tendons, which contributes to fatigue. This occurs because not moving impedes the flow of blood that is needed to bring nutrients to the muscles and to carry away the waste products of muscle metabolism. Examples of static postures include gripping tools that cannot be put down, holding the arms out or up to perform tasks, or standing in one place for prolonged periods.

●       Avoid high repetitions of movements such as prolonged typing or swiping.

●       Avoid holding large or heavy devices in one hand for a long duration.

●       Turn technology in your favor. There are phone apps available that can detect when your phone is being held at a bad angle for your neck. When the app senses a bad angle, it alerts you to hold the phone up higher. Other ideas could include setting reminders on your phone for taking breaks throughout the day and using a pedometer to track steps and activity levels, becoming more active and spending less time looking down at a screen is a good thing.

More common disorders related to Text Neck

Thumb Blues

Also called “Blackberry thumb”, this is an injury obtained from texting for hours with your thumbs. Whatever your thumb-typing speed, lots of messages mean lots of repetitive thumb motions, and that could mean trouble. The repetitive strain injury is caused by overuse of the thumbs to type messages on your smartphone or any other handheld computer with a similar keyboard. Anything that causes repeat motion can predispose someone to injuries of various sorts, whether it is tendinitis or aggravating underlying arthritis. It can cause long-lasting damage as well. These things can be made worse or even initiated by overuse, but thumb typing is very repetitive, and the keys are so small it makes it difficult to navigate around easily. The thumb isn't very nimble. It is designed as a stabilizer for pinch-gripping with a finger. That is why you only have two of them, not eight. Because it is so small, people are likely to press harder vs. a larger keyboard. So the thumb on the BlackBerry does more than you would do with your fingers on a keyboard.

So what can you do about it?

●       Switch between using thumbs and forefingers to text.

●       Use a voice-texting assistant.

●       Use predictive text functions, which suggest words for you as you type on your phone.

●       You might also just make a phone call instead.

Tired Eyes

If you’re one of those people who glance at their smartphone 150 times a day, chances are your eyes are paying the price for your screen addiction. Staring at your smartphone (or tablet, e-reader or laptop) for too long can lead to tired, itchy, dry eyes, and even blurred vision and headaches. Think zombie eyes and you’re there. Our eyes go through severe strain and stress can lead to serious eye complications like red-eyed or dry eyes which are very serious problems.

Staring at screens all day long, your eyes are getting a workout too and they can become exhausted. Smartphone screens are high definition devices which are extremely harmful to the eyes. Remember we spend 180 minutes or more on smartphones a day. That is 80 hours a month which leads to 1080 hours a year, and this is only one device! Other devices like iPads, laptops, and TVs are factored in as well.

So what can you do about it? Here are some quick and easy ways to give your eyes a break during all those smartphone marathon sessions.

●      Blinking often (and for more than a second) keeps your eyes moist and reduces dryness and irritation. We tend to blink about a third less than we normally would when we stare at our smartphone screens, which starves our poor peepers of protective tears. Keep your eyes wet by blinking about 10 times every 20 minutes or so and you should be good to go.

●      Take breaks. Sounds scary, right? But your eyes will thank you. By now you’ve probably heard of the 20-20-20 rule. The concept is to take a break from looking at your screen every 20 minutes for 20 seconds while looking at something 20 feet away. Doing so relaxes your eye muscles.  

●      Minimize glare. Unless you have a smartphone equipped with anti-glare or use a matte screen protector film, you’re probably coping with a fair amount of annoying reflective glare. The fix is easy and inexpensive: Buy an anti-reflective coating and carefully place it on your smartphone screen.

●      Adjust your brightness. Having your screen too bright or too dark stresses your eyes out and can cause problems maintaining focus. To eliminate either issue in about a matter of seconds, simply go into your smartphone settings and adjust your screen brightness so it’s about the same as the light level in the environment around you. Research shows that looking at your smartphone in bed in a dark black environment can lead to insomnia and less sexual life.  

●      Tweak your text size and contrast. Adjusting your smartphone text contrast and size also provides a little much-needed relief. It makes it easier to read web content, email messages, calendar appointments, and everything else on your phone.

●      Keep a clean screen. Routinely wipe down your smartphone screen with a dry cleaning cloth to remove distracting dust, grime, and fingerprints.

●      Hold your smartphone farther away. Most people tend to hold their cell phones only about 8 inches from their faces. Not good. Try holding yours at least 16 to 18 inches away from your eyes to give your eyes a break. It might feel funny at first but shouldn’t take long to get used to.

In summary, with all the advantages that smartphones brought to our lives, they may cause more harm than benefit. I am not encouraging you to stop using technology, but just be smart about that and use all the tips I shared with you in this podcast. I think that spine specialists, pediatricians, neurologists, ophthalmologists, public health, and social workers should run campaigns to raise awareness on musculoskeletal neck pain and its medical, psychological, and societal significances. All these smart people should develop some methods of awareness, prevention, and treatment of text-neck. Otherwise, we will see more and more young patients and adolescences knocking on our clinic door sicking for help for their neck, eyes, and fingers problems.