Text Neck

Text NeckText Neck is a new term being used to describe the neck pain and damage sustained from looking down at your cell phone, tablet, laptop etc. for prolonged periods of time. The more technical term is described as Forward Head Posture. Forward Head Posture (FHP) is a condition where the skull protrudes forward more than an inch over the vertebra in the neck on which the head rests (Sojeong Lee, 2015). Due to increased use of cellphones, tablets and laptops, FHP is now very common among many adults and, increasingly, amongst teenagers.


There are many causes of FHP or text neck. These include trauma, prolonged poor posture, repetitive strain, poor sleeping and driving habits,  as well as incorrect breathing habits. However, the main focus for this article will be factors related to the use of new technologies such as smartphones, tablets and laptops.  The symptoms of FHP are intermittent to constant neck and shoulder pain, muscle fatigue, poor posture (rounded shoulders), decreased in range of motion, muscle spasms, and headaches.


In order to properly understand the effects of the FHP, a study was performed by Hansaraj, Kenneth K. MD, the chief of Spine Surgery at the New York Spine Surgery & Rehabilitation Medicine. The study evaluates neck tilt and the forces and damages it can have on the spine. In brief “The purpose of this study is to assess the forces incrementally seen by the cervical spine as the head is tilted forward, into worsening posture.’’ The results from the study were as follows: “The weight seen by the spine dramatically increases when flexing the head forward at varying degrees. An adult head weighs 10-12 pounds in the neutral position. As the head tilts forward the forces seen by the neck surges to 27 pounds at 15 degrees, 40 pounds at 30 degrees, 49 pounds at 45 degrees and 60 pounds at 60 degrees” (Hansaraj, 2014).

As illustrated  below, the increased load on the neck and the progressively greater strain on the neck and postural muscles can be easily observed:


Tips to reduce FHP / Text Neck:

  1. Avoid using cellphones, tablets or laptops for lengthy work related task such as emails, editing or research.
  2. Instead of texting back and forth with a co-worker or client,  call using a headset or hands-free option.
  3. Ensure  a proper desktop computer set-up. The upper third of the monitor should be in-line with the eyes and the keyboard and mouse level with the elbow bent at 90 degrees.
  4. Bring the cellphone or wireless device to eye-level to read.
  5. Increase text size and font to reduce leaning into the screen.
  6. Stand up or change positions every 15-20 minutes to reduce neck and shoulder muscle fatigue.
  7. Perform neck stretches and postural strengthening exercises frequently throughout the day to reduce strain and improve neck and shoulder posture.

If you believe you have, or may be showing signs of FHP, it is recommended that you consult with your family physician to determine your course of treatment. It may also be recommended to consult a registered physiotherapist or kinesiologist to work on improve neck and postural strength to reduce the risk of FHP. In a work related setting, an ergonomic assessment would be also be beneficial. The regulated health professional has the knowledge to evaluate your workstation to assess the risks, educate on proper positioning and behaviours, as well as provide proper recommendations to address your specific needs.

Works Cited

  • Hansaraj, K. (2014, Nov). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical Technology International(9), 227.
  • Sojeong Lee, H. K. (2015). Head flexion angle while using a smartphone. Journal of Ergonomics, 58(2), 220-226.