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April 06, 2016

Infrequently Asked Questions: How do you avoid 'text neck'?

The world is full of questions we all want answers to but are either too embarrassed, time-crunched or intimidated to actually ask. In the spirit of that shared experience, we've embarked on a journey to answer all of the questions that burn in the minds of Philadelphians -- everything from universal curiosities (Why do disposable coffee cups still leak?) to Philly-specific musings (How does one clean the Liberty Bell?). 

Stiff neck? You may want to reconsider why that is.

"Text neck," or a stiff neck from tilting your neck down to your phone, continues to gain traction as a health concern as we all adapt our lifestyles to technology. But because so many of us are -- like it or not -- stuck with computers and smartphones, the more practical question at hand becomes this: Is there really any way to avoid text neck? 

We asked Jefferson University Hospital's Dr. Jack Jallo, a neurosurgeon who specializes in reconstructive spine surgery, to explain.

For starters, what is 'text neck' from a medical standpoint?

'Text neck’ is a colloquial term for what would be neck pain associated with poor posture, that posture resulting from spending too much time with a mobile device or screen. Texting, in particular.

Why you're having neck pain is a result of strain on the muscles and joints of the neck, resulting from poor posture. The reason you have that poor posture is you’re spending perhaps too much time in an awkward position, this head-bent-forward position while using a mobile device.

What’s the long-term implication for your health?

No. 1 is chronic pain. No. 2, there’s concern this forward-bent posture of the neck can affect neck alignment or the normal curvature of the neck. No. 3, it can predispose you to – your neck is a series of joints with discs at each level, so your bones stack on top of each other with vertebral discs in between. The bent forward position increases the pressure that those discs see. The concern is that this bent-forward position may aggravate wear-and-tear on those discs.

So, how can someone avoid text neck?

There are a couple ways, in terms of management. No. 1, is if you can avoid the offending posture. [Laughs] But it’s hard to do that – we’re all attached to our devices. 

But No. 2 is to modify the way you use [your devices]. Imagine your neck in a normal alignment standing upright; so, one option is to bring the device higher up to your line of sight. Another option is, rather than bending your neck down, to use your eyes as much as your neck to look at your device. Additionally, you can strengthen and stretch your cervical musculature. That can include taking pause throughout your day – whether it’s from your laptop screen, computer screen or phone screen -- to do some basic stretches. Standing upright, move your neck in an extended range of motion. And you can also work on strengthening the musculature of your neck, and that generally involves isometric exercises involving your neck.

What about if you already have symptoms? How can you relieve those?

If the symptoms don’t resolve as you adapt your environment, there's a variety of therapy options. In terms of physical therapy, cervical traction and massage therapy that can very much help the symptoms.

Is someone more at risk if they're perhaps staring down at a computer for an eight-hour day, as opposed to looking down at their phone intermittently throughout the day?

I think it depends how much time you spend on your device and whether you get breaks. If you're spending eight hours a day on the device, you're certainly more at risk than someone who maybe looks at their device for five minutes every hour across the span of the day. Those eight hours should be broken up every hour or so. I think just getting up and walking is very good. Better than that is stretching. But better than that is walking, stretching and doing some range-of-motion exercises or isometric exercises to strengthen neck muscles.

How prevalent is this condition?

So we’re seeing it – I’m a surgeon, and this isn’t something that falls in the domain of spine surgery very often. But it will be interesting to see what the long-term implication is of this on disc degeneration over time, which happens to all of us as we age. What we are really seeing is young people coming in with neck pain who have relatively normal MRIs. So the MRI normally looks at nerves, discs and bones, and what we’re not seeing now is a way to image muscle or ligament strain, and that's what we think is happening with text neck that is causing neck pain.

Anything to add?

I think this is a real manifestation of our modern era. And, rather than us being at the mercy of our modern devices, I think the goal ought to be to have them adapt to our needs.

I think it’s another manifestation of device overuse. I remember ‘BlackBerry thumb,’ with people on their BlackBerry getting injured thumbs from overusing them. This is sort of the next issue that's a result of these new technologies.

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