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How Texting Can Give You a Permanent Pain in the Neck

The smartphone has been linked to yet another health problem: text neck

By Deborah Quilter | June 11, 2013
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Deborah Quilter is an ergonomics expert, a certified Feldenkrais practitioner, a yoga therapist and the founder of the Balance Project at the Martha Stewart Center for Living at Mount Sinai Hospital in New York. She is also the author of Repetitive Strain Injury: A Computer User's Guide and The Repetitive Strain Injury Recovery Book.

Ronda Savoy's neck started aching about a year ago. "When my mother died," the 57-year-old New York real estate broker says, "I started playing Words With Friends," a smartphone game app that's a lot like Scrabble. "It's the game Alec Baldwin got kicked off a plane for playing. I played it in bed. But this put my neck in a horrible position."

Savoy had a history of neck and shoulder tension, and had worked hard to improve her posture. But after she started playing the game, she developed severe neck pain.

"I can just feel the stress," she says. "I have massages because my muscles are so tight across the back of my neck."
 
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Savoy's chiropractor initially attributed her pain to stress. Months later, she found herself using the phone to text more often – and play Words With Friends – and her pain got even worse.
 
Savoy was suffering from "text neck," a very real malady associated with smartphone use. Savoy had a classic sign of the ailment, serious stiffness in her neck, but like many other 50-somethings, she'd had pain in the area before, making it harder to realize the phone's role in her new problem.

2 Trillion Texts, Thousands of Achy Necks

There's no reliable estimate of the total number of people living with the stiffness, pain and muscle strain of text neck. But with 2.19 trillion texts being sent annually by U.S. customers, there are millions of potential sufferers.

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It takes time, though, for awareness of a new condition to spread throughout the medical community. Some doctors who have never heard of text neck don't think to ask patients with neck pain about their phone or computer habits.

Worker's compensation investigators, on the other hand, are well aware of the link between smartphones and neck pain, says Dr. Robert Markison, a hand surgeon and clinical professor of surgery at the University of San Francisco. And they're using that knowledge to get cases dismissed. 

Since individuals' text records are discoverable, claims examiners are now contacting service providers to find out how often claimants have been texting. "Then," Markison says, "they call the consulting physicians and say, 'This person is texting 30 to 40 times a day.' They are trying to attribute the neck injury to personal texting rather than work."

Smartphones are an integral part of many people's lives. But as research into the physical effects of using the devices has increased, scientists have discovered that neck pain may be only the beginning of phone-related problems. A 2011 study published in the International Journal of Occupational Safety and Ergonomics found that 53 percent of mobile phone users suffer numbness or neck aches. Another, potentially more troubling study, led by Professor Erik Peper of San Francisco State University and published in the journal Applied Psychophysiology and Biofeedback, discovered that 83 percent of subjects reported some hand and neck pain during texting — but also displayed other signs of tension, like holding their breath and increased heart rates. Participants in Peper's study experienced these physical symptoms of tension while texting even when they believed they were relaxed, he reported.
 
Keep Your Head Up

Most people adopt a forward-and-down head position while they text or play games on their smartphones. Judith Gold, a researcher at the Center for Musculoskeletal Research in Gävle, Sweden, found in a study of 859 subjects that 90 percent held their necks flexed (defined as more than 10 degrees forward of neutral alignment) while texting. The more the participants in her studies texted, she says, "the greater the chance that they would experience neck or shoulder pain."
 
The physical stress of texting adds to the accumulated buildup of pressure in neck muscles already strained by the amount of time many of us spend in a flexed posture while sitting at desktop computers. Holding your head in such a posture can add up to 30 pounds of extra weight on your upper vertebrae which, in addition to straining the upper fibers of your trapezius muscles, can pull your spine out of alignment. When typing intently, "the shoulder muscles seem to enter the state of low-level continuous contraction," Dr. Frank Wilson explained in his book The Hand: How Its Use Shapes the Brain, Language and Human Culture. "This is an abnormal state for these muscles and even though the muscular forces may be small, unrelieved muscle contraction by itself is enough to cause neck and shoulder pain."

Those of us in midlife and beyond are particularly susceptible to text neck, says Rob Worth, a physical therapist in Appleton, Wis. The condition is fundamentally an overuse injury, he says. "People in their 50s and 60s have less tissue tolerance," Worth says. "Overuse injuries don't heal as quickly." Such injuries to our soft tissues are more likely to recur as well.

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That doesn't mean younger people are less at risk. Worth suggests you take a look at typical young adults' postures while they peck away at their touchscreens. In 15 years, he says, that's probably how the users will always look, because once your alignment gets out of whack, it tends to become frozen over time.

The first step in treating text neck is seeking a diagnosis. If you have relentless neck pain that is unrelieved by rest, exercise, adjusting your posture or holding your phone differently, see a doctor for a thorough evaluation.

Physical therapy can often be quite helpful. It can relieve pain, lengthen shortened muscles, help you regain full range of motion and learn better postural habits. But while physical therapy can get you out of pain in the short term, the results won't hold up if you resume the smartphone routines that provoked your pain in the first place.

Savoy has changed her habits to limit recurrences of text neck. She still plays Words With Friends, but less compulsively. With the help of her yoga teacher, she has adopted better posture, begun using relaxation techniques and started holding her phone differently and for shorter periods.

If you're a regular smartphone user, follow these tips to reduce your risk of text neck:
  • Hold your phone up when you text or play games, instead of looking down. Position it at a proper reading angle, directly in front of your mouth at a comfortable viewing distance, a few inches across from your chin. This allows you to avoid strain because you can look at the screen by gazing down with your eyes rather than bending your neck. Your shoulders should also feel relaxed when you're interacting with the screen. If they're not, adjust your position.
  • Dictate. If your phone's texting app has a dictation program, use it – again, holding the phone in front of your mouth.
  • Take frequent, regular breaks. Excessive use is a key factor in text neck, so avoid prolonged bouts of texting, gaming, surfing or reading emails. If you tend to lose track of time while using your smartphone or lack the self-control to put it down, download a timer app and set it to remind you to take a break after 5, 10 or 15 minutes.
  • Support your range of motion. When you take time to exercise something other than your texting thumbs, focus on movements that strengthen your neck, back extensors, rhomboids and latissimus dorsi muscles. For some effective stretches, check out Peper's blog.
  • Stay hydrated. Proper hydration all day long eases stress throughout the body, from your neck down. "Your cervical spine discs, and every other body part, will thank you," Markison says.
  • Communicate with friends and family another way. Leave a voicemail, send an email from your (hopefully ergonomically correct) desktop computer, or better yet, get together in person to share a cup of coffee, with your phones safely stowed away.