Text Neck: The Physical Consequence of What Some People Deem a New “Social Disease”

Communicable Diseases 441 views
Written by Mai Lahoi

How much of a toll is device-driven life taking on our bodies? Experts weigh in, including on the weight of your head.

Text Neck: The Physical Consequence of What Some People Deem a New “Social Disease”

It seems only yesterday when three of us were at dinner with a young woman who had just been admitted into a prestigious medical school. She was ruminating about choosing a specialty, and feeling a lot of pressure to do so.

As a chorus, we three chimed, “Eyes, Ears and Neck. By the time you’ve finished school there will be a vast need for treatment of self-inflicted neck and head injuries.”

She was about to correct us that the specialty was actually called ENT when she caught our meaning. You mean “text neck! I’ve actually thought about that.”

So, apparently, have enough people that the idea has, however belatedly, made the New York Times Smarter Living section, as a fascinating and wide-ranging article called “Keep Your Head Up: How Smartphone Addiction Kills Manners and Moods.”

Indeed, the Times did consult Miss Manners on the subject of smartphone manners, such as that’s not an oxymoron. But a notable amount of its article addressed the self-inflicted physical and even physiological damage of—let’s call it “heavy”—smartphone use.

While we’re on the matter of section placement, you may ask what is this doing in our Communicable Diseases section. Well, as we were reading the Times story, the line from the Jets’ song in West Side Story, “Gee, Officer Krupke,” popped unbidden into our un-ear-podded minds.

Gee, Officer Krupke,

We’re down on our knees,

‘Cause no one wants a fellow with a social disease.

In fact, it’s a subject on everyone’s scattered minds. This is not the first time smartphones have figured in our blog. Most of the other times were about issues of addiction, depression, and combinations of both as they affect teenagers in particular. Here our focus here on the noted medical downsides of smartphone use, not including the psychological and psychiatric.

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Everyone uplugged? Eyes up?

Unless you have a forehead fetish, you’ve noticed, with or without concern or alarm, that people stuck to their smartphones spend an inordinate amount of time looking down. The problem when crossing a busy city intersection is obvious, particularly if the down-looker is wearing earbuds. The problem for selfie takers has included things like stepping backwards off cliffs to get better self-views and views of friends. Out favorite local story was of the hapless woman who wanted a selfie with a crocodile in the wild. It’s probably for the best that the camera was swallowed too.


With barely a segue from Miss Manners, the Times went on to the matter of “text neck.” It referred readers to a Reuter’s article that was itself reporting a research study published in June 2017 issue of The Spine Journal, the latter paywalled but available at https://www.sciencedirect.com/science/article/pii/S1529943017300967.

The unsurprised authors of the report in The Spine Journal noted that they are seeing more people with neck and upper back pain more of whom are younger than one might expect to have under normal, i.e., pre-21st-century, conditions. Reuters quoted Todd Lanman, a spinal surgeon at Los Angeles’ Cedar Sinai Medical Center and a co-author of the research in The Spine Journal, as saying:

“In an X-ray, the neck typically curves backward, and what we’re seeing is that the curve is being reversed as people look down at their phones for hours each day. By the time patients get to me, they’re already in bad pain and have disc issues. The real concern is that we don’t know what this means down the road for kids today who use phones all day.

“For today’s users, will an 8-year-old need surgery at age 28? In kids who have spines that are still growing and not developed, we’re not sure what to expect or if this could change normal anatomies.”

Lanman and co-author Dr. Jason Cuellar added that their research confirmed what previous studies had found, namely, that most people using smartphones, particularly texting, hold their heads down at a 45-degree angle—and more when they sit rather than stand. The problem is physiological stress.

The average head in a “neutral position” weighs between 10 and 12 pounds. A mere 15-degree flex makes that absolute weight feel like more like 27 pounds. It increases by degree, and at 60 degrees, the stress on the spine is equivalent to 60 pounds.


The doctors have suggestions to alleviate the physiological stress on the spine:

·      Hold the phone in front of the face or at eye-level while texting

·      Text using two hands and two thumbs to keep movements more symmetrical

·      Keep computer and laptop screens as close to eye-level as possible

Reuters contacted Gwanseob Shin of the Ulsan National Institute of Science and Technology Ergonomics Lab in South Korea, for a “second opinion.” Shin’s response raised additional concerns.

“It is difficult to recommend a proper posture for smartphone users. If we raise the phone at eye level to avoid the look-down posture, it will add new concerns for the shoulder due to the elevated arm posture.

“A more practical recommendation would be frequent rest breaks or some physical exercise that can strengthen the neck and shoulder muscles. Some apps can give alarming signals to users to avoid prolonged looking-down posture.”

Lanman similarly encouraged smartphone users to focus on posture and do specific exercises. One involves lying on the bed onyour back with the head hanging over the side, to help restore the neck’s normal arc. For users who are sitting, he recommends keeping the ears over the shoulders and the shoulders over the hips for improved neck and spine alignment.

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Attention, and ‘inattentional blindness”

The Times found several experts to roundly refute the idea that being on smartphones in social settings enhances group communication.

It also cited studies from the Pew Research Center that found that 24% of adolescents are effectively online “constantly.” A Nielsen study reported that adults spend an average of 10 hours a day “consuming electronic media.”

One strongly negative result is what author Henry Alford, in his book Would It Kill  You to Stop Doing That: A Modern Guide to Manners, called “inattentional blindness.” The Times backed up Alford’s claims with information from other public-safety sources, as follows:

“The National Safety Council reports cellphone use makes drivers more accident prone than drunk driving, causing 1.6 million crashes annually, mostly from young people ages 18 to 20. One out of four accidents in the United States are caused by texting.”

There’s something uplifting about being where you are, head held high—and saving everyone the pain in the neck of preventable injury.