Ever heard of text neck? You hear this term bandied about nowadays. It’s a coined term which is supposed to explain why neck pain is so prevalent because we spend so much time looking down at our screens.

Makes sense right? We tend to crane our necks forward when looking at screens which can load the back of the neck muscles. So the conclusion we make is the more we use our smart phones, the more likely we’ll experience neck pain.

Neck pain is the fourth cause of disability globally (Smith,2010). The amount of time spent on screens has been excessively present in the information age so it seems logical to clear things up a bit and investigate the biomechanical relationship and the wide prevalence of neck pain.

But what do you think the literature says?

This study I’m about to refer to challenges this assumption/relationship.

‘This study did not show an association between text neck and neck pain in 18–21-year-old young adults. The findings challenge the belief that neck posture during mobile phone texting is associated to the growing prevalence of neck pain’ (Damasceno et al, 2017).

The study asked 150 young adults from ages 18-21 which posture they most frequently use. Then, physiotherapists categorized their answers into, ‘1=normal, 2=acceptable, 3=inappropriate, and 4=excessively inappropriate’ (order from left to right in above picture).

Although more than half of the kids chose the ‘inappropriate’ posture, there was still no association between posture and pain and frequency of pain.

What caught my eye is the majority spent more than 4 hours on their phones daily! And yet less than half the kids (37%) only reported they felt some neck pain.

Conclusion: Though it might seem obvious that overdoing the ‘turtle posture’ while looking at our phones would lead to neck pain, it’s not necessarily so. We can’t rule out posture/biomechanics just yet because this is just one study but the fact that half the kids exhibited ‘text neck’ postures and less than half (i.e., 37%) reported pain means contributeions to the experience of pain vary.

Can we experience pain after 4 hours of screen time? That’s a hell yes!

Are we doomed to have pain if we do? Not at all. And that’s the distinction we need to make. Maybe by planting the idea that texting posture is horrible creates more stress and therefore pain.

And what about the context in which the screen time is done? I’m betting that kids enjoy their time on the phone so there’s inherently a positive experience which lends value to this activity. If compared to a context with an office worker who hates their job staring at a screen all day, I’m willing to put my money on a greater likelihood of more pain reports.

I also have an issue with the fear mongering message that ‘text neck syndrome’ carries because it creates fear in folks. Once people start believing peering down at their phones is dangerous, which is an activity that’s here to stay BTW, then this will induce a mistrust of their bodies.

A comfortable body has no postural rules to adhere by where all movements are thoughtless, fearless, and effortless. What happens when we give ourselves strict postural rules? We give it a threatening valence or value. And that threat can incite a painful experience.

And now for some fun

Because therapy isn’t always about the negative side of things…. = )


  1. Damasceno, GM., Ferreira, AS., Nogueira, LAC., Reis, FJJ., Andrade, ICS, Mezhiat-Filho, Ney (2018). Text neck and neck pain in 18-21-year-old young adults. European Spine Journal. https://doi.org/10.1007/s00586-017-5444-5
  2. Smith, E., Hoy, Dg, Cross, M., Vos, C., Naghavi, M., Buchbinder, R., Woolf, AD., March, L. The global burden of other musculoskeletal disorders: estimates from the Global Burden of Disease 2010 study. Ann Rheum. http://dx.doi.org/10.1136/annrheumdis-2013-204680).

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