The inexorable rise of “text neck”

Occupational health professionals are always stressing the importance of getting up from your desk and moving around. Using our smartphones to access digital content has long been a part of everyday life. We check our emails, surf the web and send messages around the clock. On average, we spend 2 to 4 hours a day stooped over these tiny screens and not just at home on the sofa: at the bus stop, on the train and even while walking.

But all this takes a toll on our bodies: Constantly staring at and tapping our smartphones and tablets means our necks are under constant pressure even though we may not notice it. The more you tilt your head downwards, the greater the pressure you’re putting on your cervical spine. According to a U.S. Study conducated in 2014: tipping your head forward by 15 degrees applies a force of 12 kg. At a 60 degree angle this increases to 27 kg. “Try carrying 12 kg on your head – that’s a lot of weight”, says physiotherapist Raymond Denzler.

As team leader of physiotherapy in the spine department at the Schulthess Klinik in Zurich, he has observed that poor posture has generally increased in people over the last 15 to 20 years. There are more and more posture and neck complaints - and not just among people who work in offices. According to a Harvard study conducted in 2012, excessive tablet use means we don’t move our shoulder joints enough and subject them to poor posture. This can result in pain and restricted mobility known as “iPad shoulder” which is similar to tennis arm. Like “text neck”, the term doesn’t have a proper medical diagnosis. However, Denzler is certain that excessive use of tablets and smartphones is definitely one of the causes of this type of complaint.

What exactly happens to our bodies when we bend our heads over our smartphones? Experts say that subjecting your body to this position for long periods of time can have an effect on the structure of the thoracic spine: muscles, joints, ligaments and discs are overstrained through one-sided use. The constant stretching of the structures reduces their blood supply. This means that there is no proper supply, which causes the muscles to cramp. If the neural pathways are also affected, some muscle fibres are forced to do the work of those not adequately supplied with blood and are overburdened which causes pain. This triggers pain. People often don’t complain about the pain until much later, sometimes in combination with other aches and pains. “Young people are able to compensate for longer. They tend to complain about the pain a lot later down the line”.

• Hold your smartphone more frequently at eye level instead of bending your head down.
• If you type with one hand: Change hands frequently. Or even better: use both hands to write.
• Use a hands-free kit or headset for phone calls.
  

• Change position frequently and use your breaks for quick exercises: Move around on your chair, stretch your arms and head upwards, bend your upper body forwards and rest your elbows on your thighs, stand up, walk around, circle your arms.
• The computer screen should be at least an arm’s length away from your eyes (60 to 90 cm). Position your monitor directly in front of you so you’re not forced to turn your head when working. The top of the screen should be at eye level or slightly below.
• Sit up straight from time to time: Raise your head as if it’s being pulled upwards by a thread. Your ears and shoulders should be aligned.
  

• 3 months of weight training might be enough to alleviate your back pain.

A small change in attitude would have a very positive effect: For example, hold the smartphone higher and in front of the face rather than under it - for example, when writing every second text message. Simple tips are also helpful in the office: sitting on the chair, occasionally stretch your arms towards the ceiling or tilt your upper body backwards and then lean forward. “A few simple changes is all it takes to counteract one-sided strain. According to Denzler, it's also not a problem to slouch a little when sitting or to flop down on the sofa at home - just not in the same position for three hours. “Ideally you should change position every 20 to 40 minutes. That’s the best piece of advice I give all my patients” says Denzler.

We humans are designed to be physically active, which is why regular physical exercise is the best means of preventing back and neck pain. Weight training, back strengthening exercises, backstroke and front crawl are particularly good ways of strengthening your back. However, walking and hiking are also very beneficial. It should be fun and something you’re willing to stick at and not give up after a couple of weeks.