The DCs ultimate guide to tech neck

There’s absolutely no question that we love our high tech gadgets.

In fact, in the time it would take you to finish reading this article, you have almost certainly gotten or sent more than one text or email. Over the course of a single day, more than 4 billion people around the world will send almost 19 billion text messages.¹ Americans are responsible for approximately half of those texts.

Furthermore, Americans text on a weekly basis and are twice as likely to communicate by text message as by talking on the phone.¹ If we look at email statistics, more than 3.7 billion people around the world send out 269 billion emails each day.² Americans also lead the way in the number of emails sent and received.

As with many other technological advances in today’s fast-paced world, all of this time spent sending and receiving texts and emails comes at a price. In this case, it’s a painful phenomenon, mainly affecting the neck and shoulders, which has become known as tech neck.

What causes this painful condition, what are its symptoms, and how can it be treated?

What causes tech neck?

Tech neck happens when people spend too much time with their head and neck extended too far forward over their body while looking at a computer screen. It can also happen when people repeatedly tuck their head down over their chin and hunch their shoulders while sending or receiving text messages on a cell phone.

At 0 degrees of head tilt (neutral neck), your head weighs about 12 pounds. As you can imagine, the further forward the head tilts and the neck bends, the heavier the head becomes. By 30 degrees of head tilt, your head weighs 40 pounds. By the time your head is at 60 degrees, it weighs about 60 pounds. It’s just like holding a small child on your shoulders.

Another way to see this is the more you look down, the more your head moves forward, shifting the center of gravity. Then the upper spine shifts backward to counteract the forward head shift. Furthermore, the hips then tilt forward to compensate for the upper spine. You can see how one area of the body under stress affects adjacent areas.

Imagine the prolonged effect all of this pressure has on the muscles, ligaments, vertebrae and discs in the neck and upper thoracic regions. Smartphone users spend an average of two to four hours a day hunched over, reading emails, sending texts and checking social media sites. That adds up to about 700 to 1,400 hours a year of extra stress people are putting on their spines. And high school students may be at most risk. They conceivably spend an additional 5,000 hours in this position.

Educating your patients on the dangers of text neck is fairly straightforward. There are plenty of posters with pictures and graphics about text neck and the dangers it presents. But as with other vices or habits, even if people know it’s bad, that may not completely stop them from doing it.

5 surefire signs of tech neck

Although neck and shoulder pain are the most common symptoms, others may also occur. These can include upper back pain, carpal tunnel syndrome, and migraines or headaches. Your patients may also notice blurry vision and sometimes even numbness in the fingers, particularly the thumbs.

1. Pain in the neck

One of the main signs of tech neck is a stiff or painful neck. This is caused by spending most of the time with the neck in a downward position while looking at the phone or laptop computer.

Keeping it in this position actually puts additional weight onto the spine. In some cases as much as 60 pounds of pressure may be added.³

Tell your patients to hold their phone in such a way so as they won’t be tilting their head down as much. Gentle neck stretches may also help.

2. Shouldering the burden

In addition to neck pain from texting on a cell phone, the other tell tale sign of tech neck is shoulder pain.³Because phones are small, many people end up hunching their shoulders in order to hold the phone in one hand while texting with the other.

Improper ergonomics while sitting in front of an office computer can also lead to hunching over the keyboard.⁴

Your patients should give their shoulders a break by stretching them out periodically and practicing gentle shoulder rolls, both forward and backward.

3. Headaches

Headaches can be common either from tilting the head down to read the display on cell phones or from having the head too far forward over the shoulders while reading a computer monitor.^3,4 Both of these positions will leave the head over-balanced, which may trigger headaches.

Suggest that your patients lift their phones up to eye level and re-adjust their work environment so that they are sitting upright with the computer monitor at eye level.⁴

4. All thumbs

Tingling or numb thumbs can occur with cell phones because that is the finger most often used for texting. If your patients hunch over their phone, they are pinching the nerves leading down the arms to the hands and fingers.³

Suggest your patients shake out their hands, wriggle their fingers, and do gentle wrist rolls from time to time. Numb or tingling hand and fingers can also happen with a keyboard if the forearms and wrists are not properly supported.

There are ergonomic wrist supports that your patients can use with their keyboards to place the wrists in a neutral position.⁴

5. The eyes have it

Spending an excessive amount of time staring at a computer screen or phone display can cause blurry vision from glare. In addition, when we are focused on our tasks, we do not blink as often, so the eyes become dry, which can also lead to blurriness.

The end result from not seeing as clearly will be even more of a tendency to hunch over the phone or move the head even further forward toward the computer monitor, which compounds the problem of tech neck.⁴

Your patients will benefit from taking a tech break to rest the eyes for five to 10 minutes, along with use of lubrication drops. Reading glasses may also help for older patients.

There is no doubt that advances in technology, such as smart phones and personal computers have revolutionized how we communicate and interact with the world around us. However, there are drawbacks to all of our high tech devices.

However, if we learn to take breaks and pace out the amount of time we spend on the phone or computer, we can hopefully prevent conditions such as tech neck from either starting or getting worse.

​Tips to reduce tech neck

Any or all of the following strategies can mitigate the risks posed by excess use of electronic devices:

• Hold the device at eye level as this negates the need to crane your neck.
• Look down with your eyes and not your head.
• Take a three-minute break for every 15 to 20 minutes spent on your device (you can set auto reminders for this). The more typing you do, the more frequent you should take breaks.
• Use a phone or tablet holder so your arms and shoulders can relax.
• Be mindful of your posture. Your head should be in a neutral position, your wrists straight and your shoulders as relaxed as possible. Tensing muscles in the neck and shoulders will lead to chronic muscle issues and pain.

Adjustments for tech neck

Be mindful of the forces being placed on the cervical and upper thoracic vertebrae in the forward translation directions. It is important to evaluate the C/T transition area and the upper thoracics.

Supine or standing anterior thoracic moves work well for these areas. If you pre-stress the C/T region properly, you can get the lower cervicals to shift comfortably with an anterior thoracic. Prone C/T moves as well as supine modified rotary break (MRB) or seated RB moves can work as well, but that will take out rotation more so than anteriority. Use your hands and they will tell you what you need to move and how to do it.

Notice occiput/C1/C2 involvement. Keep in mind that both suboccipitals do not have to be involved. It may be one or the other. Whichever occiput is inferior, look for atlas laterality on the ipsilateral side. Additionally, look for C2 to be involved on the contralateral side.

The use of spring loaded or other handheld adjusting devices instead of your hands can work when appropriate. These devices are also helpful in breaking up some of the muscle tightness.

Elastic sports taping for tech neck

Another approach is to place two pieces of 2-inch tape beginning below the hairline on each side of the neck. These continue down along the spine and end up around the mid to lower scapulae. It may seem counterintuitive, but have the person bend their neck forward comfortably as you place the tape down from the neck down the spine to the thoracic area. The pre-stress gives the tape the “elastic snap-back effect” for good support. You can also teach basic exercises for patients to perform as self-care:

• Neck extensions: moving the head backward.
• Neck side bends.
• Neck rotation to both sides.

Repeat each of the above exercises while pushing your head into your hand for some resistance.

Like it or not, text neck is here to stay. Mobile devices are becoming more popular, not less. Patients will likely be coming to you because their pain is becoming worse. Now it is your turn to spread the word and help those patients heal.

​References