Text Neck: Does Using Your Phone Too Much Really Cause Neck Pain?

The evidence is mixed, but most studies show a correlation between the use of electronic devices such as phones, e-readers, or tablets, and pain in the neck and shoulders (2). Harvard Medical School reports that “looking down at a smartphone or a laptop for long periods of time can cause neck pain” (3). However, other research shows little to no association between neck pain and electronic device usage (4).

The difficulty of assessing the relationship between texting and neck pain is compounded by psychological factors that alter physiological outcomes. For example, whether or not you think you have bad posture that will result in neck pain can influence your experience and description of your neck pain. More research is needed in order to understand the exact nature of the relationship between device usage and neck pain.

Although some studies suggest a correlation between neck pain and texting, they don’t show a clear causative relationship (5). Bearing that in mind, electronic devices do directly result in a sharper angle of neck bending. Whether this increased bending specifically causes pain isn’t clear, but it’s fair to say that the general angle of a bent neck when someone is using a device certainly constitutes subpar, forward head posture (6).

Some research suggests that while excessive use of electronic devices won’t cause the onset of neck pain if you don’t already suffer from it, texting or other device usage may exacerbate any neck pain that you already experience (7).

If you regularly use electronic devices, pay attention to how much you’re bending your neck as you text on a mobile phone, scroll on a tablet, or type on a laptop. Assess the ergonomics of the desk, chair, or couch where you typically use your device. Reduce the angle of bending by lifting the device up to eye level, propping it up in front of you, or placing your laptop on a small stack of books. Tablets tend to be worse for posture than cell phones or laptops, so try to limit your use of tablets in particular (8). Whenever possible, take frequent breaks from electronic devices and take some time to analyze your posture.

Research suggests that people often struggle to self-assess good posture correctly, so take your time sitting up straight, lengthening your spine, and holding your head upright (9). The Mayo Clinic has a few recommendations for checking your posture and familiarizing yourself with what a good head position should feel like (10):

• Wall test: Stand with the back of your head, shoulder blades, and buttocks touching the wall. Your heels should be about 2 to 4 inches from the wall. Straighten and flatten one hand then slide it between your lower back and wall. This will help you achieve a proper lower back curve. If there’s a lot of room between your lower back and the wall, attempt to draw your bellybutton to your spine. You’ll feel the curve reducing and your back nearing your hand and the wall. If there’s too little space between your back and the wall, arch your back slightly so that your hand can slide in and out with ease. Walk around for a few minutes then return to the wall to see if you’re able to maintain proper posture.
• Walking experiment: Begin to walk, then stand as tall as you can as you’re moving. Take a deep breath in, roll your shoulders up, release your breath out, and roll your shoulders down.
• Pelvic tilts: Sit on the edge of a chair with your hands resting atop your thighs and feet on the floor. Breathe in then tilt your pelvis and ribs forward. Expand your chest and look at the ceiling. Breathe out then rock back and look at the floor.
• Bridge pose: Either first thing in the morning or before going to bed, lie on your bed on your back. Bend your knees and rest your feet on the mattress. Breathe in slowly, then breathe out slowly and lift your buttocks and spine off of the bed one vertebra at a time, as though you’re curling up your spine. Keep going until your weight rests on your shoulder blades. Hold the pose as you take a deep breath in, then release your breath slowly as you uncurl your spine until your back is flat against the mattress.

Physical Therapy

The cornerstone of treatment for neck pain or a stiff neck should be physical therapy. There’s significant evidence that physical therapy is an effective, low-risk option for relieving neck pain (11). You may want to speak to your primary healthcare provider about a referral to a local physical therapist.

Make sure that the therapist accepts your insurance policy and has office hours that work with your schedule. During your initial visit, take your time in asking the questions you need answers to in order to feel comfortable at therapy. Your physical therapist will touch you and instruct you in how to move your body to reduce pain, so make sure you feel able to relax with the therapist. Some questions you may want to ask include:

• How many times per week do you recommend appointments?
• Will you give me exercises to do at home? 
• How long do you foresee the treatment taking?
• Have you successfully treated others with pain similar to mine? 
• Are there supplemental treatments I can apply at home — like heat therapy, cold therapy, or exercise — that might accelerate pain relief in conjunction with physical therapy? 
  

Pain Medication

Over-the-counter medications like non steroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Aleve) and ibuprofen (Advil) can relieve neck pain and be used concurrently with physical therapy. Prescription-strength NSAIDs like diclofenac gel is useful for treating acute neck pain (12). If pain persists, muscle relaxants like cyclobenzaprine and antidepressants can treat neck pain (13).

NSAIDs carry a risk of heart problems and stomach pain. Muscle relaxants can cause dry mouth, fatigue, nausea, and drowsiness, and antidepressants may cause dizziness, headaches, and sweating. Speak to a healthcare provider about your personal and family medical history to determine the potential benefits and effects of pain medications for you.‍

Alternative Therapies

Heat therapy can provide relief for sore neck muscles. Apply heat for 10-15 minutes by taking a hot shower, holding a warm, damp towel to your neck, or using a heating pad (14). Take care to protect your skin by wrapping hot objects in a towel before applying them to your skin.

Cold therapy can ease neck pain by numbing the painful area and reducing inflammation. You can purchase a cold gel pack at a pharmacy or online, or make a cold pack at home: 

• Ice towel: Soak a towel in cold water. Wring out the towel, fold it up, and zip it into a plastic bag. Freeze the pack for 15 minutes. Remove and apply to your neck.
• Ice pack or cold compress: Fill a plastic ziploc with ice. Fill the bag partially with water then squeeze the air out of the bag as you seal it. Wrap a damp towel around the bag and place it on the painful area (15).

Radiofrequency denervation (RFD), a treatment which involves heat-based injections, can offer short-term relief for chronic neck pain, but more research is needed to substantiate its efficacy. Acupuncture can help with neck pain as well (16).‍

Stretches

Supporting your spine is a critical part of keeping neck pain at bay, or responding to it if it does arise. Harvard Health recommends the following stretches to increase your spine support and prevent neck pain (17):

• Chair stand: Sit in a chair with your feet on the floor. Space your legs hip-width apart. Rest your hands on the tops of your thighs. Engage your abdominal muscles and breathe out as you slowly rise from the chair. Then slowly lower until you’re sitting again. Repeat this exercise 8 to 10 times.
• Heel raise: Stand straight with your hands resting on the top of a chair. Place your feet hip-width apart and distribute your weight evenly between both feet with your spine in a neutral position. Engage your abdominal muscles and rise up onto your toes until you’re standing on the balls of your feet. Take care not to let your ankles roll. Slowly lower your heels until you’re standing firmly on the ground again. Repeat this exercise 8 to 10 times.
• Standing side leg lift: Stand behind a chair with your hands resting on it. Keep your feet together and distribute your weight evenly. Once you feel confidently balanced, lift one leg to the side. Keep your foot turned in and try to raise it six inches from the floor. Repeat this exercise 8 to 10 times then switch legs. 
• Front plank on table: Stand up straight in front of a table. Bring your feet together. Engage your abdominal muscles then slowly bend your upper-body until your forearms rest on the table. Bring your hands together, interlace your fingers, and make sure your shoulders align with your elbows. Step back into the balls of your feet. Keep your back straight and engage your full abdomen and spine like you would in a full plank. Hold this pose for 15 to 60 seconds.

While the research is mixed, overall there does appear to be an association between electronic device usage and neck pain. However, there’s no clear causative relationship between texting and neck pain at this point in the research. Maintaining good posture and limiting device usage is still a good, proactive way to limit the chance of developing neck pain. Especially in the case of tablet usage, minimizing time spent on electronic devices may help keep neck pain at bay.