Is This You?

Who thinks that the above and below postures lead to neck pain or discomfort? They are a common sight now since smart phones have become widely available.

There is a general consensus that the flexed (or forward bending) posture of the neck and head while reading and typing, also known as text neck is harmful, and is related to neck pain and other physical discomfort.

This impression that neck pain is caused by excessive smartphone use started after one computational model study in 2017 suggested that the greater the neck bending forward, the greater the overload. The theory is based purely on biomechanics and does not consider that pain is multifactorial and modulated by several factors.

Previous studies did not find an association between text neck and neck pain. Bertozzi et al (2023) also did not find an association between neck posture and time spent on smartphones with neck pain or disability.

The present study aims to investigate whether text neck is a risk factor for neck pain, while considering the influence of psychosocial and lifestyle factors. This longitudinal study with a 12 month follow-up using a self reported questionnaire and objective assessment of posture while sending messages on a smartphone. 

396 participants (87 percent) completed the 1-year follow-up. Average age of the participants was 27 years. 319 (70 percent) were female. The average neck flexion angle using the smartphone was 34 degrees. Only 4 subjects (1 percent) had neck pain "very often", 20 subjects (5 percent) had neck pain "often". 129 subjects 33 percent) had neck pain "occasionally", 158 subjects (40 percent) rarely had neck pain 85 subjects (21 percent) "never" had neck pain.

The researchers concluded that neck flexion posture was not a risk factor for neck pain or frequency of neck pain. They found that psychosocial factors like low sleep quality and insufficient levels of physical activity were contributing factors of neck pain.

So it's not really just what position you neck is in or how long you spend on your phone that can cause your neck to hurt. However, if you spend a lot of your time on your phone, please make sure you get in enough exercise and sleep well to avoid neck pain.

Reference

Correia IMT, Ferreira ADS, Gomes JFM et al (2025). Cervical Flexion Posture During Smartphone Use Was Not A Risk Factor For Neck Pain, But Low Sleep Quality And Insufficient Levels Of Physical Activity Were. A Longitudinal Investigation. Braz J PT. 29(6): 101258. DOI: 10.1016j.bjpt.2025.101258