Blog Post

“Text Neck”: Postural Bogeyman or Made-up Condition?

We have an unhealthy obsession with posture, and the physical therapy, medical, and health and fitness worlds are mostly to blame. 

Well, maybe our mothers are mostly to blame. After all, they’re the ones that first scolded us for slouching and reminded us to sit up straight. Though, their reasoning was probably less about preventing pain and spinal degeneration and more about just not looking like a lazy slob.

But, it was those brow-beaten children who grew up into physical therapists and doctors that took the idea of “bad posture” and theorized it into the cause of all manner of maladies, mostly those involving the spine such as back pain, neck pain, disc herniations, degenerative disc disease, etc. The thing is, these ideas were all just logical leaps–albeit biologically plausible ones–that medical practitioners used to explain why someone ended up with spine pain. Nowadays the idea is so entrenched in our collective understanding of musculoskeletal pain that it just seems like a given. 

But it’s not a given. 

Well done studies conducted throughout the years repeatedly show that posture has a poor correlation with neck and back pain. But these are tiny voices yelling out in the hurricane of misinformation that is repeated by countless doctors, PTs, trainers, fitness magazines, health gurus, and the like.

The latest bugaboo of the posture police is “Text Neck,” the belief that people looking down at their phones for long periods is the cause of neck pain. 

It seems plausible. Your neck is bent forward at an extreme position for hours a day, your muscles are straining, your ligaments are tense, yadda yadda yadda. Surely, that leads to pain. But consider the fact that there are an estimated 6.5 billion smartphone users in the world. That’s 80% of the world population. Neck pain is a fairly common complaint as far as medical conditions go, but it’s nowhere close to 80%. It’s more like 2.7% of the population in a given year.1 If looking down were so dangerous we would expect to see a lot more people with neck pain. 

Moreover, looking down is not a new thing we all started doing when we got smartphones. Humans have been doing this since they started working with tools and continuing with the creation of books and the advent of newspapers. It wasn’t a problem then and it’s not a problem now.

“Newspaper neck” epidemic in the 1940s

A 2007 study looked at neck curvature, which is often assessed by x-ray in people with neck pain, to see if there was a correlation between curve and neck pain. It is commonly assumed that a straightening of the neck’s natural curvature is a problem that should be corrected with special exercise in order to fix neck pain. The study found that there was no correlation between straight necks or curved necks and pain.2

Another study categorized 686 17-year-olds into 4 neck posture subgroups and followed them for 5 years to see who got neck pain. No neck posture was related to neck pain in males. In females, upright posture was associated with the onset of persistent neck pain whereas a slumped posture actually decreased the chances of getting neck pain!3 How’s that for a nail in the coffin?

And for “text neck,” specifically? A study of 150 18-21-year-olds found no correlation between neck posture while texting and intensity or frequency of neck pain.4

So looking down while using a phone doesn’t lead to neck pain. 

But…that doesn’t mean that using your smartphone for hours when you already have a sore or painful neck won’t make your neck hurt. In that case, you’re putting a bit of strain on an already sensitive structure. That can hurt and it’s worth modifying your posture and habits to decrease that strain and let your neck feel better. That’s not the same as texting causing neck pain.

If neck pain isn’t a problem for you, don’t fret about your smartphone use damaging your neck. If you are having neck pain or you’re prone to it, maybe consider limiting your time on your phone (or book or newspaper) or holding it up higher so you don’t have to look so far down. It’s as simple as that.

If you’re having neck pain and are looking for help give us a call at 221-989-4678, or you can click here to inquire.

1. Kazeminasab S, Nejadghaderi SA, Amiri P, et al. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskeletal Disorders. 2022;23(1):26. doi:10.1186/s12891-021-04957-4

2. Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J. 2007;16(5):669-678. doi:10.1007/s00586-006-0254-1

3. Richards KV, Beales DJ, Smith AL, O’Sullivan PB, Straker LM. Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Phys Ther. 2021;101(3):pzab007. doi:10.1093/ptj/pzab007

4. Damasceno GM, Ferreira AS, Nogueira LAC, Reis FJJ, Andrade ICS, Meziat-Filho N. Text neck and neck pain in 18-21-year-old young adults. Eur Spine J. 2018;27(6):1249-1254. doi:10.1007/s00586-017-5444-5