Very recently a new patient came to see me for osteopathic treatment because she had neck and shoulder pain.

This young lady works long hours in health-care, and especially so as a manager, she spends much of the day at a computer then once at home she really enjoys catching-up with her friends and interests on facebook and twitter on her phone.

What surprised me was not her description of increasing headache, neck and shoulder pain and the tension I detected in her body, but the emotional aspects of her experience. She was anxious, fatigued and teary. I now find research relating to ‘text neck’ so coined in 2008, and ideas that explain both aspects of this.

How Text Neck affects our bodies

Neck and shoulder pain (NSP) is caused when our bodies are held in an abnormal position whilst using hand-held devices. Chris Cornett (Orthopaedic Surgeon), and Kenneth Hansraj (Chief of Spine Surgery in New York) describe this overuse and the numerous reasons it leads to poor posture.

In essence, our neck muscles become tensioned and the cervical spine is placed under load as we look down and the position of our head held increasingly forward.

Logically, the longer we do this for the more likely we are to feel pain and surprisingly, worse if we use our phones with one hand rather than two. Hakala found NSP is provoked after an average of just two hours of using hand-held devices and low back pain soon follows after four. Yanfei describes ‘altered motor control’ whereby our elbow, wrist and thumb muscles are measurably and excessively activated by both supporting the phone and keying with the same hand. Early in treatment, I am always surprised how tense these muscles and reluctant the joints to move, but how they improve. Samj identified extreme symptoms of RSI in his research of adolescents in Hong Kong; they blistered their thumbs.

Feeling worse with Text Neck

The result is a ‘painful tensional syndrome’ and most interesting this research leads to an understanding that NSP is a sign of physical and mental loading leading to emotional consequences. Our bodies are under stress and as such vital physiological systems are activated leading to fatigue and anxiety. It mirrored my findings with the patient.

How to help Text Neck

What helped the patient was to separate day from night and put a plan in place for me to help her, help herself. If we are going to use these devices, limit their effect. I’d like to share some advice she found helpful with you.

1. Start by asking someone to take a picture of you using your phone at work and at home.

You don’t see yourselves in an awkward posture, you slowly feel it, but don’t realize the cause. Use this to reposition everything, you and your chair, desk. Keep adapting your environment to suit a new posture and try different approaches. Use the photographs to track your progress.


2. Sit-up – avoid slumping, in addition to NSP you limit the amount of oxygen you breathe when slumped over your phone.


3. With your head as far up as is comfortable, use your eyes to look downward. Keep your ears over your shoulders, it is awkward but hold the phone as high up as you are able to.


4. Set the alarm on your phone and set out what you want to do by when.

I know this is counter to what you wish to do when you’re not at work, but literally hours can go by and by diminishing return and enjoyment.


5. Decide how late.

The light on the phone or i-pad is stimulating your daytime/nightime sensors via the eyes to the pineal gland. This is one of the reasons people become exhausted.


6. Get up for 10 minutes in every hour. Stand and stretch.

Sitting with head forward and shoulders slumping shortens muscles at the front of the body and stretches those at the back. Reverse that posture.


7. Use both hands to support the phone and key texts.


8. How often do you stretch and exercise? The stronger the muscles to counter-balance any time spent with a forward posture the better.


9. Keep on going with attempting to improve your posture … it takes time! Good posture is when you feel comfortable, with no pain. Your body is not exerting unnecessary energy to keep you there.


10. Exerting control over the multiple causes of these symptoms is something you can do and believing you can change it helps reduce the stress associated with them.



I hope these measures help. And finally ‘I’m frequently asked ‘how long before the pain will go away and I feel better?’. The body and our emotions do respond, but as a rule of thumb, when you make these changes and have osteopathy treatment, it can take as long for symptoms to retreat as it took to acquire them in the first place, so be patient.