Text Neck Syndrome

Pushplata Arya, PT
Asst. Prof.
School of allied medical and health sciences
Introduction of Text neck syndrome - In the modern era of smartphones, tablets, and
laptops, a growing concern has emerged regarding the impact of prolonged device usage on our
physical health. One notable consequence is the development of what is colloquially termed
"Text Neck Syndrome."
Neck pain is a prevalent health problem, largely reported in adult patients. However, very recent
data show that new technologies are inducing a shift in the prevalence of this relevant issue from
adulthood to all of the pediatric ages. In fact, the precocious and inappropriate use of personal
computers and especially cell phones might be related to the development of a complex cluster
of clinical symptoms commonly defined as “text neck syndrome”.
Findings support the contention that an appropriate approach for an early diagnosis and treatment
is crucial to properly evaluate this emerging issue worldwide in children and adolescents who
spend a lot of time watching smartphones and computers; additional research with more rigorous
study designs and objective measures of musculoskeletal pain are needed to confirm significant
relationships. Existing evidence is limited by non-objective measures and the subjective nature
of musculoskeletal pain.
Definition - Text Neck Syndrome refers to a musculoskeletal condition characterized by
discomfort, pain, and strain in the neck, shoulders, and upper back, primarily caused by
prolonged and repetitive forward head posture while using electronic devices such as
smartphones, tablets, and computers.

Overview-The term "Text Neck" was coined due to the prevalent habit of individuals hunching
over their devices, craning their necks forward to view screens for extended periods. This posture
places excessive stress on the cervical spine, resulting in muscular imbalances, joint dysfunction,
and potential structural changes over time.

As digital technology becomes increasingly integrated into daily life, Text Neck Syndrome has
garnered attention from healthcare professionals, ergonomic experts, and individuals seeking
relief from its debilitating effects. From adolescents engrossed in social media to professionals
spending hours on end in front of computer screens, the prevalence of Text Neck Syndrome
spans across age groups and occupations.

Understanding the factors contributing to Text Neck Syndrome, its symptoms, and the potential
long-term implications is crucial in developing preventive strategies and effective management
approaches. Through education, ergonomic adjustments, and mindful device usage, individuals
can mitigate the risks associated with Text Neck Syndrome and promote overall musculoskeletal
health in the digital age.
Anatomy of Modern spine condition- Head drifts forward and down towards our device:

 The lower cervical spine connecting to your shoulders and upper back goes into
hyperflexion, flattening out the natural C-shaped curvature of the spine.

 The upper cervical spine connecting to your skull goes into hyperextension, making the
spinal curve more pronounced.

This puts extra pressure on the intervertebral discs, vertebrae, and connecting facet joints, which
can exacerbate spinal degeneration. It also causes that spinal canal to lengthen through the neck,
increasing stretch and tension on the spinal cord and nearby nerve roots. In short, o

The anatomy of the cervical spine is complex and unique. The cervical spine has seven
vertebrae, which may be divided into two groups that are distinct both anatomically and
functionally: the upper pair (C1 and C2, the atlas and axis) and the lower five (C3–C7), The
upper cervical spine has the first and second vertebrae – the atlas and axis – and forms a unit
with the occiput.
The lower cervical spine is composed of the third to the seventh vertebrae which are all very
similar. Each vertebral body is quite small . Its height is greater posteriorly than anteriorly and it
is concave on its upper aspect and convex on its lower. On its upper margin it is lipped by a
raised edge of bone. The anteroinferior border of the vertebral body projects over the
anterosuperior border of the lower vertebra. Anterolateral (in the upper vertebrae) to
posterolateral (in the lower vertebrae) on the upper surface of the body, two uncinate processes
project upwards and articulate with the lower notches (or anvils) of the upper vertebra to form
the joints of von Luschka or uncovertebral joints. Laterally, the transverse processes have an
anterior and a posterior tubercle,

which are respectively the remnants of an embryonic rib and transverse process. The spinal nerve
lies in the groove between the two tubercles. The transverse process also has a transverse
foramen for the vertebral artery and vein. This is not so at C7, where the foramen encloses only
the accessory vertebral vein. The intervertebral foramina are between the superior and inferior
pedicles. The articular processes for the articulation with the other vertebrae are more posterior.
The two laminae blend together in a bifid spinous process (at C3, C4 and C5). The spinous
processes of C6 and C7 are longer and taper off towards the ends. C7 has a large spinous process
and is, therefore, called the vertebra prominens.
The cervical spine has a complex ligamentous system. Ligament function is to maintain normal
osseous relationships. Clinically, however, they are not so important because ligamentous lesions
in the cervical spine are not that common and, when they occur, it is difficult to find out where
exactly the problem lies.
Muscular action at the cervical spine is dependent on a combination of activities of a great
number of muscles and whether or not they contract bilaterally or unilaterally. There are three
functional groups: flexors; extensors; and rotators and lateral flexors. Most muscles do not have
clinical importance, in that lesions of them hardly ever occur. However, they can sometimes
indirectly involve other (non-contractile) structures. On examination a resisted movement
(muscular contraction) or a passive movement (whereby the muscle is stretched) may influence a
lesion lying outside the muscle in, for example, an inert tissue. One contractile structure makes
an exception however: an acute lesion of the longus colli causes, besides pain and weakness on
flexion, serious limitations of extension and both rotations . It should be noted that the function
of many of the muscles is multiple and depends on the mode of action employed. For example,
bilateral action of the sternocleidomastoids is involved in flexion–extension, but unilateral action
results in ipsilateral lateral flexion and contralateral rotation . Unilateral action of the flexors
results in either pure rotation or lateral flexion, or a combination of both, sometimes ipsilaterally
and sometimes contralaterally. Many of the extensor muscles have other functions as well as
extension, the latter occurring when they act bilaterally.
 Causes of Text Neck Syndrome- Some of the main causes include:

1. Poor Posture: Holding the head in a forward and downward position for extended periods while
texting, browsing the internet, or playing games on electronic devices can strain the muscles,
ligaments, and tendons of the neck and upper back.

2. Increased Device Usage: The prevalence of smartphones and other handheld devices has
led to an increase in the amount of time people spend looking down at screens. Continuous use
without breaks can exacerbate neck strain and contribute to text neck syndrome.

3. Muscle Imbalance: Prolonged use of electronic devices can lead to muscle imbalances in the
neck, upper back, and shoulders. The muscles on the front of the neck may become tight and
overactive, while the muscles on the back of the neck and upper back may become weak and
overstretched, further contributing to poor posture and neck strain.

4. Screen Position: The height and angle of the screen can also contribute to text neck syndrome.
Holding devices too low or too high forces the neck into an unnatural position, increasing strain
on the muscles and supporting structures.

5. Sedentary Lifestyle: Spending long hours in sedentary positions, such as sitting at a desk or
lounging on a couch while using electronic devices, can weaken the muscles of the neck and
upper back and contribute to poor posture.

6. Stress and Tension: Stress and tension can exacerbate neck pain and discomfort associated with
text neck syndrome. Increased stress levels may lead to muscle tension and stiffness in the neck
and shoulders, further aggravating symptoms.

7. Lack of Awareness: Many people are unaware of the potential health risks associated with
prolonged device usage and poor posture. Lack of awareness may lead to neglect of proper
ergonomic practices and exacerbate text neck syndrome.
 Sign And Symptoms-Common symptoms caused due to text neck include soreness and neck
pain, Stiffness,Headaches,Shoulder and Upper Back Pain,Tingling or Numbness in the Arms

. Constantly, putting one’s gaze to look downward at the cell phone each day may lead to the
following signs and symptoms:

a. Pain in the upper back ranging from continual nagging ache to sharp and extreme pain

b. Tightness in and around the shoulder joint, resulting in muscle spasm and shoulder pain

c. Chronic neck spasms leading to cervical nerves getting pinched between vertebras, resulting in
possible neurological symptoms with radiation of pain down to the arm and forearms

d. Heavy smartphone and tablet users are at risk of muscle fatigue and restriction of their neck
movements. This eventually results in their reduced work capacities. The reason is the continual
fatigue of occipital muscle tissue which causes the formation of metabolites at some stage in

muscle contractions, which alter the stability because of the activation of tonic gamma motor
neurons.

Management - Both nonpharmacological and pharmacological treatment options in primary,

Nonpharmacological management –

a. Correct holding of smartphones, tablets, and e-readers at degree with the eyes must be
practiced so that abnormal posture of the neck can be avoided

b. Sitting up in a straight posture with ears overs the shoulders while using the
phone/tablet/e-reader prevents forward hanging of the head

c. Reduction in screen time is a good option. The use of the 20-20-20 rule is a must in such
circumstances. That means we must gage at something that is 20 or more feet away, after every
20 minutes for at least 20 seconds. In addition, it can prevent the “computer vision syndrome”

d. Users of smartphones and other electronic devices must use their both hands while texting. It
is advisable to use the index fingers to text – not both of your thumbs as what is usually practiced

e. Standing up after every 20 minutes, rolling down the shoulders back and fro, and walking
around help to relax the muscles and allow an individual not to be stuck in one position only

f. Use of cervical pillow, using elevated computer monitor, and installing mobile apps which
give alarming alerts, are often found useful

g. Smartphones or tablets must no longer be used for extended computer work as it is nearly
impossible to maintain our correct body position during working
h. Helpful physical activities as recommended by spinal surgeons comprised chin-tuck exercise,
neck side tilt, neck turns, shoulder blade pinches, pec stretch, and prone Y extension.

Pharmacological management - It includes pain management through nonsteroidal