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Home Ergonomic Trends

Text Neck Syndrome: Ergonomic Problems And Solutions

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April 21, 2022 - Updated on September 14, 2022
Reading Time: 9 mins read

People who use mobile devices tilt their heads to operate them. This posture causes text neck syndrome — severe strain in the neck and shoulders. Once muscles adapt to these positions, they pull the entire spine out of alignment. If left unchecked, this leads to stiffness, pain, and serious musculoskeletal disorders.

Text neck ergonomic problems and solutions
Text neck syndrome bends the neck forward, causing a severe rounding of the upper spine.

An adult human head weighs around 10-12 pounds. Most people crane their necks forward by 45° when using mobile devices. This places 50-60 pounds of force on the neck. That’s five times more than the normal load.

Over a year, the average smartphone user will spend around 1200 hours(1) in this position (3 hours per day). That builds up as severe strain in the spine, cervical ligaments, and surrounding muscles.

Text neck syndrome effects
Text neck starts as upper body pain. If untreated, it can distort the entire spine into a severe state of kyphosis.

At first, strain manifests as neck and shoulder pains. Stiffness, tingling limbs, and frequent migraines are common symptoms. Over time, these lead to more serious problems. These include:

  • Thoracic kyphosis: excessive forward curvature of the upper back. This tightens hamstrings and stiffens the upper back.
  • Spinal disc degeneration: slumped postures wear down spinal discs. At first, this limits movement. Once degenerated discs leak fluid, swelling and pain emerge.
  • Chronic fatigue: misaligned muscles burn more energy than normal to hold the body up against gravity.

Mobile Use Strains Neck And Shoulders

Mobile computing with a downward head position distorts a healthy cervical spine curvature. To compensate for the misalignment, neck and shoulder muscles must work harder.

Text neck problem

Over time, this stress builds up — until the body breaks down. This will render you immobile, lethargic, and in constant pain. Then, you’ll have no energy (or motivation) to turn things around.

Prevent this from happening to you by educating yourself. This section explains how excessive mobile usage affects both the neck and shoulders.

Mobile User Neck Strain

When using a mobile device, most people tilt their heads forward by 45° or more. This position strains the neck, shoulders, and eventually the spine.

Text neck angles and head pressure

The logical antidote is to balance the head so that it doesn’t tilt in either direction. Specifically, a neck flexion of 0-15° is best for mobile computing(2). This range best reduces muscle activity in the Cervical Erector Spinae (CES) and Upper Trapezius (UT).

Best mobile neck position
The perfect neck position balances the head above shoulders with a 0° tilt.

But the perfect neck flexion angle is 0°. A head balanced precisely above the shoulders helps you to maintain crisp neutral postures. In those positions, muscle activity is the lowest — from head-to-toe!

Embody chair mid-back support
Perfect neutral sitting postures keep the head balanced evenly atop the shoulders at all times.

For instance, neutral postures in a Herman Miller Embody chair keep the head in a 0° tilt through all ranges of motion.

Mobile Usage Shoulder Strain

Most mobile ergonomic studies focus on the neck. A recent Khon Kaen University study (3) shed light on shoulder stress caused by mobile computing. 32 students performed texting tasks with a steady 0° neck flexion (head balanced perfectly atop the shoulders).

Then, they alternated among four different shoulder flexion angles: 15°, 30°, 45°, and 60°. Muscle activity was measured in the CES, UT, lower trapezius (LT), and anterior deltoid (AD).

Ergonomic arm support prototype device for smartphone users
This mobile arm prototype supports a 0° neck flexion and 30° shoulder flexion.

Results showed AD and LT muscle activity increased as shoulder flexion angles did. A 30° shoulder flexion proved the best compromise of activation levels among the four muscles. This angle also induced the lowest neck and shoulder discomfort scores.

Corporations Ignore Text Neck

Throughout ergonomic history, workplace designers have consistently glossed over several genuine human factors. For example, schooling became mandatory for American kids in the 1800s.

Classroom ergonomic standards in the past and present
Classroom ergonomics in 2022 are the same as they were in the 1800s.

Soon after forced full-time sitting emerged, student back problems skyrocketed. Despite this, unhealthy student seating hasn’t evolved in over 200 years! This trend looks to continue with text neck syndrome.

Text neck degeneration
In the corporate world, text neck problems are swept under the rug as back problems have been.

Today, around 6.5 billion people (83.7% of the global population) have smartphone subscriptions(4). Apple generated $180 billion from iPhone sales in 2021. The amount spent researching text neck solutions caused by their products: zero.

Technostress Problems Are Yours Alone!

Humans are not designed to sit all day in sedentary positions. In the computing era, doing so has yielded several forms of technostress. There is physical technostress (like text neck), mental (information overload), and addiction (hooked on notifications).

On the institutional design front, sedentary health risks and text neck problems are both being ignored. The 5th edition Handbook of Human Factors And Ergonomics came out in late 2021. This is the world’s leading reference for institutional workplace design.

Handbook of Human Factors and Ergonomics 5th edition
The latest fifth edition frames multi-device computing as the greatest ergonomic priority of our time.

The previous 2012 edition cited office chair back support as a key priority of the time. The 2021 version shifts priorities to focus on multi-device computing support. The new challenge is to figure out ways to get people to spend more time in sedentary, text-neck positions!

However, circa 2022, endemic sedentary lifestyles are one of the greatest health issues of our time. Despite this, in its 1603 pages, the word ‘sedentary’ is only mentioned six times! The phrase ‘text neck’ is not even mentioned once!

This is why megacorporations like Apple earn billions selling phones but ignore the problems they cause. It’s also why the most cutting-edge science for healthy mobile computing comes from places like tiny little Khon Kaen University in Thailand.

Bottom line: business demands excessive texting time but ignores the physical costs. To maintain a healthy posture in mobile-heavy times, the only one you can count on for physical support is yourself!

Text Neck Solutions

Your boss doesn’t care about your craned neck — but will compel you to keep craning it. Text neck syndrome starts out as neck and shoulder pain. Then comes chronic lethargy and a rounding of the upper spine. If you don’t address this, no one will.

A slumped upper back places excess pressure on the spine. 22% of the global population suffers from musculoskeletal disorders.

Predictably, lower back pain is the leading cause of disability in 160 countries(5). Other text-neck-related MSDs:

  • Neck pain: the fourth-leading cause of disability in America.
  • Shoulder pain: causes around 4.5 million USA doctor visits per year and $3 billion in health costs.
  • Chronic fatigue: around 25% of American adults report feeling chronically fatigued(6).

Circa 2022, text neck syndrome can be tackled using three different approaches.

Chiropractic Solutions

A tour through ergonomic history shows that most back doctors have no idea what they’re doing. For instance, when schooling became mandatory for American kids in the 1800s, back problems skyrocketed.

Posture correction devices in in 1855
Posture correction methods from 1855.

To address those, the doctors of that era literally made up solutions with no theoretical basis. Circa 2022, most chiropractors will address text neck problems with (pricey) back alignment sessions.

These mainly involve massage techniques using pressure points and flexion exercises(7). There are a few problems with this method. First, there’s no way to know for certain that it works. Second, the chiropractic industry has a long history of shady practices based on bunk science.

Perfect posture competition in America
These posture ‘doctors’ in the 1950s had no idea what they were doing.

Third, a 2008 review found that beyond easing back pain, chiropractic manipulation has not been shown to be effective for any medical condition(8).

DIY Mid-Back Chair Posture Rehab

If not keen on chiropractic back alignment, why not align your spine yourself at home? This method uses ergonomic science, muscle memory biomechanics, and a mid-back ergonomic chair.

Embody chair mid-back support
Perfect neutral sitting in an Embody chair keeps the head balanced evenly atop the shoulders.

Any mid-back chair with adjustable arms and adjustable lumbar support will do. That said, the very best chair for the job is the Herman Miller Embody.

Unlike other chairs, the Embody prioritizes support to the thoracic part of the spine. With emphasized upper back support, balancing your head evenly above the shoulders is comfortable and easy.

Embody Backfit system for thoracic support
The Embody’s Backfit supports the thoracic spine first and the lumbar spine second.

Don’t sweat it if you can’t afford a $1795 Embody. Any mid-back chair with adjustable lumbar support, adjustable arms, and a reclining backrest will do.

Text Neck Posture Therapy With A Mid-Back Chair

Ergonomic Arm Support Prototypes

The preceding Posture Rehab method doesn’t prevent text neck behaviors. Rather, they seek to override the effects caused by text neck syndrome. That’s because ergonomic text neck prevention tools are still in the prototype stage.

Ergonomic arm support prototypes for mobile device users
L-R: Khon Kaen U. School of Physical Therapy prototype; Autofull Mecha Master arms; ChairsFX lapboard.

The good news is Khon Kaen University’s 2021 research. That gave the world ideal flexion angles for both the neck (0°) and shoulders (30°). Moving forward, this data should help to bring some versions of existing arm support prototypes to market.

Summary of Mobile Arm Support Prototypes in 2022

Sit-Stand Desk Mobile Support

The above study suggests a 30° shoulder bend while texting to preserve a 0° neck tilt. At present, sit-to-stand desks come the closest to supporting that position.

Healthy texting postures using a sit-stand desk for support
Standing desks can support heathy texting postures while sitting or standing.

Beyond supporting mobile postures, shifting from seated to standing positions is good for you! The transition resembles a squat. Each squat works the hips, bones, muscles, and joints.

Woman working her hips while sitting and standing at a computer desk
Work your hips, legs, and spinal muscles every time you switch from sitting to standing.

Today, mobile neck support and sedentary computing solutions are huge ergonomic priorities at the institutional level. Given the mobile and movement support that standing desks provide, they’re likely to explode in popularity in the coming years. Learn more:

Multi-Device Ergonomics: Why You Need A Sit-Stand Desk

Conclusion

Here’s the text neck syndrome gist:

  1. Around 87% of the world (6.5 million people) have mobile phones.
  2. The average mobile user spends 3 hours daily in texting positions.
  3. Most users tilt their heads 45° to use their phones. This exerts 50 pounds of extra pressure on the neck and shoulders.

Today, around 22% of the population (1.7 billion) suffer from MSDs. Lower back pain is the leading cause of disability in 160 countries. Neck pain, shoulder pain, and chronic fatigue are endemic.

But here’s a way out. Humans are born with perfect body mechanics. But the body adapts to (and remembers) the positions it holds most often. As life gets in the way, many people forget what healthy body mechanics are!

Fascial network integrates into every part of the entire body
Fascia is a thin connective tissue that acts like a programmable intelligent mecha.

Luckily, circa 2022, healthy computing mechanics (and methods) are very clear. Studies show that with proper instruction, people can train themselves into healthy positions.

How to use muscle memory to boost health
Knowledge + discipline can lock muscles into healthy long-term patterns.

After a short period of disciplined effort, magic happens. First, muscles adapt to healthy positions, thereby relieving themselves of exertion. Then, the fascial system will harden around your new posture and lock it into muscle memory!

So if back pain or text neck is wearing you out, here’s your ticket out. (Simple and intuitive) biomechanical knowledge + an ergonomic chair + a few days of discipline can literally change your life!

Use Muscle Memory To Forge Healthy Ergonomic Habits

Footnotes

  1. Pablo Robles. ‘Why your smartphone is causing you text neck syndrome’. January 25, 2019. https://multimedia.scmp.com/lifestyle/article/2183329/text-neck/index.html, (accessed 10 April 2022).
  2. Suwalee Namwongsa, et al. ‘Effect of neck flexion angles on neck muscle activity among smartphone users with and without neck pain’, Ergonomics. 2019 Dec;62(12):1524-1533. DOI: 10.1080/00140139.2019.1661525, (accessed 11 April 2022).
  3. Weerasak Tapanya, et al. ‘Ergonomic arm support prototype device for smartphone users’, Applied Ergonomics Volume 95, September 2021, 103458. https://www.sciencedirect.com/science/article/abs/pii/S0003687021001058, (accessed 11 April 2022).
  4. Daniela David, et al. ‘Text Neck Syndrome in Children and Adolescents’. Int J Environ Res Public Health. 2021 Feb; 18. DOI: 10.3390/ijerph18041565, (accessed 11 April 2022).
  5. ‘Musculoskeletal conditions’. WHO Fact Sheets, 8 February 2021. https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions (accessed 12 March 2022).
  6. Dr. Stephen Gluckman. ‘Chronic Fatigue Syndrome’, Perelman School of Medicine at The University of Pennsylvania, September 2021. https://www.msdmanuals.com/professional/special-subjects/chronic-fatigue-syndrome/chronic-fatigue-syndrome, (accessed 11 April 2022).
  7. Dr. Ryan Russell. ‘What Methods Does A Chiropractor Use To Align Your Spine?’ May 7, 2019. https://www.integrativechirocenter.com/uncategorized/what-methods-does-a-chiropractor-use-to-align-your-spine/, (accessed 11 April 2022).
  8. Wikipedia. ‘Chiropractic controversy and criticism’. Last updated April 2, 2022. https://en.wikipedia.org/wiki/Chiropractic_controversy_and_criticism, (accessed 11 April 2022).

Anil Ramsey

Anil Ramsey

I'm the ChairsFX founder and Chief Editor. I'm a member of the OSHA Education Center Association (OECA), with an OSHA Ergonomics Certification. Beyond these credentials, I've been hands-on testing the world's finest ergonomic desk chairs since 2018. Learn more about me and this website on the About Us page.


 

Table of Contents

  1. Mobile Use Strains Neck And Shoulders
    1. Mobile User Neck Strain
    2. Mobile Usage Shoulder Strain
  2. Corporations Ignore Text Neck
    1. Technostress Problems Are Yours Alone!
  3. Text Neck Solutions
    1. Chiropractic Solutions
    2. DIY Mid-Back Chair Posture Rehab
    3. Ergonomic Arm Support Prototypes
    4. Sit-Stand Desk Mobile Support
  4. Conclusion

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