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And it seems increasingly common. Recently, a patient came in to my practice complaining of severe upper back pain. He woke up and was experiencing severe, acute, upper back muscle strain. I told him I believe the pain is due to the hours he was spending hunched over his cell phone. Diagnosis: Text neck.

Of course, this posture of bending your neck to look down does not occur only when texting. For years, we've all looked down to read. The problem with texting is that it adds one more activity that causes us to look down—and people tend to do it for much longer periods. It is especially concerning because young, growing children could possibly cause permanent damage to their cervical spines that could lead to lifelong neck pain.

What are the symptoms associated with text neck?

Text neck most commonly causes neck pain and soreness. In addition, looking down at your cell phone too much each day can lead to:

• Upper back pain ranging from a chronic, nagging pain to sharp, severe upper back muscle spasms.
• Shoulder pain and tightness, possibly resulting in painful shoulder muscle spasm.
• If a cervical nerve becomes pinched, pain and possibly neurological symptoms can radiate down your arm and into your hand.

I believe, as some studies suggest, text neck may possibly lead to chronic problems due to early onset of arthritis in the neck.

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How common is text neck?

A recent study shows that 79% of the population between the ages 18 and 44 have their cell phones with them almost all the time—with only 2 hours of their waking day spent without their cell phone on hand.1

How is text neck treated?

First, prevention is key. Here are several pieces of advice for preventing the development or advancement of text neck:

• Hold your cell phone at eye level as much as possible. The same holds true for all screens—laptops and tablets should also be positioned so the screen is at eye level and you don't have to bend your head forward or look down to view it.
• Take frequent breaks from your phone and laptop throughout the day. For example, set a timer or alarm that reminds you to get up and walk around every 20 to 30 minutes.
• If you work in an office, make sure your screen is set up so that when you look at it you are looking forward, with your head positioned squarely in line with your shoulders and spine.

The bottom line is to avoid looking down with your head bent forward for extended periods throughout the day. Spend a whole day being mindful of your posture—is your head bent forward when you drive? When you watch TV? Any prolonged period when your head is looking down is a time when you are putting excessive strain on your neck.

Next, rehabilitation is important.

• Many people don't know this, but you need to have strong core muscles—the abdominal and lower back muscles—to support your upper body, including your neck. Your core muscles usually do not get enough exercise during normal daily activities, so you need to do specific exercises to target these muscles.
• You also need strong and flexible muscles the neck to minimize strain on your cervical spine and help support the weight of your head. Again, your neck will not get sufficient stretching and strengthening during normal daily activities, so it is best to learn specific neck exercises with the help of a health professional.

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