Text Neck

Text Neck

Article by John Miller

Text Neck

What is Text Neck?

Text Neck is an overuse syndrome or a repetitive stress injury to the neck caused by holding your head forward and downward for extended periods. When keeping your head in this position, excessive amounts of tension are created in the deep muscles of your neck and across the shoulders, causing both acute and chronic neck pain. Chronic cervicogenic headaches are associated with this condition.

The increased prevalence of these pains is due to the increasing popularity and hours people spend on handheld devices such as smartphones, e-readers, iPads and tablets.

What Exactly Causes Text Neck?

text neck

When in an upright posture, your ears should align with the centre of your shoulders. In this position, the weight of the average head exerts approximately 4.5 to 5.5 kgs of force through your neck muscles. Approximately six times as much force!!! That’s about 30kg – the same weight as an average 8-year-old! However, when your head is moved forward by only 2 to 3 cms away from this neutral position, your head weight dramatically increases these neck forces.

If left untreated, a ‘text neck’ can lead to the inflammation of the neck ligaments, nerve irritation and increased curvature in the spine. It can also develop an upper thoracic postural deformity known as a “dowagers” hump, resulting in alteration of the bone structure of your vertebrae in this region.

Signs and Symptoms of Text Neck

Text neck may have one or more of these signs and symptoms:

  • Instant or delayed-onset upper back or neck pain when using a handheld device,
  • Nagging or sharp pain in the neck or shoulders at the end of the day or postural fatigue,
  • General shoulder pain and tightness,
  • Head forwards of neck posture,
  • Intermittent or constant headaches made worse when looking down or using the computer.

For more information, please consult your neck physiotherapist or doctor.

Text Neck Treatment

Your physiotherapist conservatively manages text neck. The main aims of treatment are to reduce the tension within the neck muscles, reduce the pain within your neck and address the postures that aggravate your symptoms. Treatment will typically include postural awareness and strengthening exercises to correct for the future and prevent a recurrence.

After your physiotherapist has assessed your lifestyle, posture and neck structures, they will confirm the main issues causing your neck pain. They will utilise a range of treatments, including

PHASE I – Reducing Pain & Inflammation

Pain and inflammation are potent inhibitors of healthy muscle and joint movement. Pain is the main reason people seek treatment and should be the first symptom to improve!

PHASE II – Restoring Normal ROM and Strength

As your pain settles, your physiotherapist will turn their attention to restoring your normal joint alignment and range of motion, including muscle length and resting tension, muscle strength and endurance. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises specific to your needs. They may also start you on a deep neck flexor and scapular/upper thoracic spine strengthening program to facilitate dynamic control of your neck and head.

Your physiotherapist may also recommend a stretching program or a remedial massage to address your tight or shortened muscles. Please ask your physiotherapist for their advice specific to your needs.

PHASE III – Restore Full Function

Depending on your lifestyle, your physiotherapist will tailor your rehabilitation to allow you to return to your desired activities. Everyone has different demands that will determine what specific treatment goals you need to achieve.

PHASE IV – Preventing a Recurrence

Your physiotherapist will assist you in identifying the best way to restore and maintain good posture by providing you with posture awareness prompts, taping, posture fatigue braces and exercises for you to monitor your progress indefinitely.

Other Options

Some liniments and creams, such as Fisiocrem or Flexall, can provide temporary muscular pain relief by rubbing the cream into the neck, shoulder or arm. For more information, please consult your physiotherapist, pharmacist or doctor.

Article by John Miller

When Should You Be Concerned About Neck Pain?

What's Urgent?

There is one situation where there’s no need to wait several weeks before deciding if your neck pain is serious.

If you’ve had an accident with forces that may have been sufficient to fracture your spine or tear nerves, seek a medical assessment as soon as possible. In this instance, either call an ambulance or head to a hospital emergency department.

Red Flags for Neck Pain

Otherwise, the rule of thumb is to start a more thorough medical investigation only when you meet all three of these conditions.

The three general red flags for neck pain are:

  1. it’s been bothering you for more than about six weeks
  2. it’s severe and/or not improving, or getting worse
  3. there is at least one other “red flag” (see below)

Red flags are reasons to seek a professional opinion rather than to worry. Seek the advice of your physiotherapist or doctor if any of these red flags apply to you.

  • Light tapping on the spine is painful.
  • A torn artery may cause severe, throbbing or constrictive (novel pain), with a high risk of a stroke. Pain is the only symptom of some tears. Most cases are sudden, on one side, and cause neck and head pain (in the temple or back the skull), but the pain is usually strange. Any hint of other symptoms? Promptly attend a hospital emergency.
  • There are many possible signs of spinal cord trouble in the neck, with or without neck pain, mainly affecting the limbs: e.g. poor hand coordination; weakness, “heavy” feelings, and atrophy; diffuse numbness; shooting pains in the limbs (especially when bending the head forward); gait awkwardness. Sometimes patients present with both neck pain and more remote symptoms and don't realise they are related.
  • Unexplained episodes of dizziness or nausea, and vomiting may indicate a problem with the stability of the upper cervical spine.
  • Weight loss without dieting (it's a potential sign of cancer).
  • Mystery fevers or chills, especially in people with diabetes).
  • A severe headache that comes on suddenly is a “thunderclap headache”! Most are harmless, but it is always wise to investigate thoroughly.
  • Symptoms of meningitis (inflammation of the membranes covering the brain and spinal cord, caused by infection or drug side effects). The presence of a fierce headache or an inability to bend the head forward, fever, or an altered mental state.
  • The main signs that neck pain might be caused by autoimmune disease specifically include:
    • a family history of autoimmune disease,
    • gradual but progressive increase in symptoms before the age of 40,
    • marked morning stiffness,
    • pain in other joints as well as the low back,
    • rashes,
    • difficult digestion,
    • irritated eyes, and
    • discharge from the urethra (bladder).
  • Steroid use, other drug abuse, and HIV are all risk factors for a serious cause of neck pain.
  • If you feel pretty unwell in any other way, that could indicate that neck pain isn’t the only thing going on.

More info: Neck Pain