If you’re one of eight in 10 of us who own a smartphone, you might start noticing symptoms of what’s been termed ‘tech neck’ (also known as text neck). The tell-tale signs include neck pain, reduced mobility, a forward head posture and headaches.

While there’s some controversy over whether it’s an actual diagnosis, one thing’s for sure, mobile devices are becoming a real pain in the neck for many of us. So, is your smartphone seriously harming your postural health?

What is tech neck?

Tech neck is a term used to describe the impact of modern technology, such as smartphones and iPads, which strain the neck, shoulder and back muscles. The downward tilting of the head for prolonged periods causes these muscles to strain and can result in the forward positioning of the head.

Senior physiotherapist Mark Maddison of Peak Performance Institute says increasingly he’s seeing people who are using modern technology for too long, resulting in poor posture.

“[When] a device such as a phone or a tablet sits too low, usually held in the palm of our hand below chest height, the position causes our head to tilt forward as we look down into the device.

“This sustained forward head posture requires the overuse of the musculature in the neck and upper back to work extremely hard to prevent the head from crashing into the low-held screen, resulting in tech neck.”

Consequences of tech neck

Tech neck results in many acute and chronic symptoms, says Mr Maddison, including but not limited to the following:

Stiffness
The overused muscles in the rear of the neck, shoulders and upper back become tight, which reduces the range of movement, strength, and function. 

Pain
Many structures in and around the spine can become inflamed and produce pain once overloaded. Some of these structures include the muscles, joints, discs or nerves.

Headache
The smaller muscles of the upper neck can refer to tightness in the skull, resulting from many tension headaches and migraines.

Disc degeneration
This is a part of the natural aging process of the spine. However, increased load with abnormal posture can increase the rate of disc degeneration, which has many adverse effects on spinal joints and vertebra health.

Reduced lung function
Once spinal joints become stiff, the range of motion required for rib movement becomes impaired, reducing respiratory volume and, in turn, limiting function.

Arthritis
Added load on joints in the spine by tight muscles and sustained posture increases the rate of wear on cartilage resulting in arthritis.

Prevention and reversal of symptoms

Fortunately, many of the consequences of tech neck are manageable by using some of the following techniques, advises Mr Maddison:

Massage
Relaxing tight, stiff and sore muscles assist in restoring muscle strength, range of motion, pain reduction and overall body function.

Pacing strategies
Sustained posture or strenuous activities should be spread out over a longer duration with small breaks at regular intervals, allowing muscles to recover between loads, which reduces muscle tightness.

Supported postures
While using larger devices for longer durations, use the support of tables for the device and high-backed furniture for spine and head support. When using a computer for longer than 45 minutes, ensure an ergonomic desk is set up for the user with a monitor and a separate keyboard. This ensures the correct spinal alignment and reduced spinal load. 

Strengthening
Ensuring larger and weaker muscles, like lower trapezius, rhomboids, and other back muscles, are strengthened helps to share the load across the body reducing tightness in the upper back and neck. This, in turn, reduces pain, tightness, and movement limitations.  

The negative symptoms involved with tech neck can be acute and, if not treated, evolve into a chronic condition with many symptoms and structures involved, says Mr Maddison.

“The complex nature of this condition may be challenging to tease out the exact cause, especially once the condition becomes chronic and more structures become involved.

“If you believe you have symptoms resulting from tech neck, it is best to visit an allied health practitioner, such as a physiotherapist, to ensure you are treating the correct cause of your symptoms and assisting your recovery as soon as possible.”

Is it tech neck?

Matthew Holmes, Sessional Lecturer in Neurology and Neuroscience at the School of Biomedical and Health Sciences at RMIT University and Clinical Director at Focal Allied Health, says clinicians should look for clues when investigating neck pain in patients.

“Many times, patients suffering from tech neck may present symptoms similar to ordinary neck pain patients. These may include stiffness, restricted range of movement, pain and headache.

“Some patients may also experience referred pain in the arms from myofascial trigger points or nerve root irritation.

“The clues to the origin of their symptoms will come from questioning them about the use of technology, how long they use it for, and the postures they adopt.

“Often these patients will display an anterior or forward head positioning when you check their posture, particularly in a seated position.”

Treating tech neck depends on the tissues involved in the problem and its severity, explains Mr Holmes.

“If the patient only has mild discomfort and early postural changes, it may be sufficient to provide lifestyle advice and posture correction exercises.

“Patients with more severe symptoms, such as myofascial or nerve root involvement, may require a course of physical therapies and more graded postural rehabilitation exercises over a longer period.”

Physiotherapists have a crucial role in educating patients about prolonged use of technology, poor posture, and predisposition for neck pain and headaches, says Mr Holmes.

“We should also educate people on the need to seek care even in the early stages of this condition, as early treatment and prevention are far easier than attempting to fix the problem later on.”

Tech neck, technically true?

A recent study found a strong association between time spent using a mobile phone and the duration and severity of neck pain. The study recommended that people pay more attention to healthy sitting positions and the time spent using mobile devices to reduce neck and shoulder pain.

But physiotherapist Oliver Crossley isn’t convinced that the science stacks up when it comes to a diagnosis of tech neck, but rather is based on personal opinion or bad reasoning.

"Many labels and diagnoses for musculoskeletal pains are surprisingly made up when you dig into them a little further.

“When investigated in scientific research, tech neck has again and again been proven not to exist. Whether it’s adolescents or adults, we have yet to see any association between flexed cervical spine postures and pain or injury in the area.”

When it comes to musculoskeletal pain and pain in general, the reasons for it occurring are often more complex, explains Mr Crossley.

“We now see pain as being due to the perception or accumulation of 'threat' to our body consciously and unconsciously rather than solely due to tissue damage.”

So, whether tech neck is scientifically and technically correct, one thing’s for sure, many of us are guilty when it comes to overuse of mobile technology.

What do you think? Is tech neck real? Do you experience it, or have you seen it in your patients?