With the usage of mobile phones and computers dramatically increased we have seen an increased rate in the presentation of neck and shoulder pains. So much so that the term ‘Text Neck’ has been devised. The neck, or cervical spine, is a complex structure made up of bone, muscle, joints and nerves and acts to hold up and move the head. The term ‘Text Neck’ describes a repetitive strain injury to the neck where a person has their head in a flexed or forward position for a prolonged period of time whilst looking down at their mobile device. This applies to any form of technology.

S.Lee (2015) showed that when using a mobile phone most users maintain a flexed neck measurement somewhere between 35-45 degrees. It was also shown that this angle increases during texting when compared to other tasks. It was also higher in seated positions when compared to standing ones. This is important because this increases the load on the neck and the musculature that supports it.

Hansraj, the chief of Spinal Surgery at New York Spine Surgery, published a study in 2014 assessing the incremental increases in force applied to the neck as the head is tilted forwards into worsening postures. What was shown was the dramatic increases in the force the neck experienced as a result of postural changes (see figure below). For example when we look down to text, our neck may be experiencing up to six times the load of normal when looking down at 60 degrees! Imagine trying to lift a weight that is six times what you normally lift and do that for prolonged periods of time. Do you think you would get sore, tight and achy?

The most common symptoms of text neck are pain and soreness. As expected it was shown in a 2011 study by Berolo, that with the increasing use of smart phones, the severity of pain and soreness increased. Other studies show that poor postures, such as a forward head, slouched or rounded shoulder posture may be adopted. Due to the altered load that occurs in these postures, others complications that may arise include:

  • Altering of the spinal curvature (flattening with the loss of lordosis)

  • Onset of early osteoarthritis and spinal degeneration

  • Disc compression and bulging

  • Nerve compression

  • Headaches

So what are some things you can do to help prevent the progression of this disease and improve your symptoms?

  1. Reduce Usage

Attempt to reduce the amount of total time you spend on your phone. Also try and not spend too long in one continuous session of phone use.

  1. Improve posture during use

Hold your phone higher, as close to eye level as possible. For general posture you should think about keeping you back straight and tall, shoulders pulled back and chin slightly tucked in. If you are having trouble reading the screen increase the size of the text.

  1. Being active

Ensuring you spend some time each day getting your body moving if you’ve been seated for long periods of the day. Regardless of the activity, moving your body through a wide range of movements is best. Ensure that you change your position throughout the day, alternating between sitting and standing to reduce fatigue.

  1. Stretches

Make sure you perform a series of neck, mid back and chest stretches to maintain your mobility. See my next blog post ‘An exercise program for the desk worker.’

  1. Strengthen posture

Doing movements to strengthen the muscles of your core, back, between your shoulder blades and your deep neck flexors should be key. See my next blog post ‘An exercise program for the desk worker.’



  • Sojeong Lee, H. K. Head flexion angle while using a smartphone. Journal of Ergonomics, 2015, 58(2), 220-226.


  • Berolo S, Wells RP, Amick BC 3rd: Musculoskeletal symptoms among mobile hand-held device users and their relationship to device use: a preliminary study in a Canadian university population. Appl Ergon, 2011, 42: 371–378.


  • Janwantanakul P, Sitthipornvorakul E, Paksaichol A: Risk factors for the onset of nonspecific low back pain in office workers: a systematic review of prospective cohort studies. J Manipulative Physio Ther, 2012, 35: 568–577.


  • Bonney RA, Corlett EN: Head posture and loading of the cervical spine. Appl Ergon, 2002, 33: 415–417.


  • Hansaraj, K. Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical Technology International, 2014, (9), 227.


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