Text NeckText neck and other risks are becoming more and more common as the use of cell phones and other mobile devices increases. As of 2016, 76% of Canadians owned a smart phone (Statistics Canada, 2017) and are spending an average of 2-4 hours a day on their mobile devices (Sharan, D. et al. 2014). With technological advances, more resources are available at our fingertips from; social media, email, work resources, maps, games, cameras etc. However, as use time on these mobile hand-held devices continues to increase there have been increased complaints of pain or discomforts. These are occurring in the neck, shoulders, elbows, thumbs and fingers. It was recently reported that 70% of individuals experienced pain in the upper back and neck related to their hand-held mobile device use (Sharan, D. et al. 2014).

“70% of individuals experienced pain in the upper back and neck related to their hand-held mobile device use”(Sharan, D. et al. 2014)

Who is at risk?

Anyone who uses a mobile hand-held device frequently and for a long duration of time is at risk. Healthcare professionals have also expressed a great concern in younger individuals. These include children and adolescents frequently utilizing mobile hand-held devices (Fares, J et al. 2017). Younger individuals are reported to be operating their devices for a greater duration each day. As a result, they are being exposed to the risks of frequent use of these devices, such as; awkward postures, repetition and high forces.

What musculoskeletal disorders and injuries are related to cell phone use?

  1. Text neck
  2. Blackberry Thumb
  3. Cell Phone Elbow
  4. Digital Eye Strain

Text Neck

Text neck or forward head posture may occur from increased strain placed on your neck from looking down at mobile devices for too long. Strain on your neck muscles increases significantly when your neck is flexed downward compared to when the neck is in a neutral posture. In a neutral posture your head weighs approximately 10-12 lbs on the neck. However, when your neck is flexed to even 15° it increases the weight of your head on your neck up to approximately 27 lbs (Hansraj, KK, 2014). When utilizing a mobile phone, your neck is typically flexed at 45° increasing the force on your neck to approximately 49 lbs (Hansraj, KK, 2014). Over time this can cause stretching of the tissue, inflammation, muscle strain and can even affect the natural curvature of the spine. Neck exercises and stretches can be an effective way to treat the symptoms of text neck in addition to correcting your posture. Bring your phone up to eye level, this will reduce the amount of force placed on your neck.

Tech Neck Weight Strain

Figure 1 (Retrieved from: https://healthmatters.nyp.org/how-to-prevent-tech-neck/)

Blackberry Thumb

Blackberry Thumb also known as De Quervain’s Tenosynovitis refers to inflammation of the tendons that connect your thumb to your wrist (ASSH, 2017). It leads to a painful snapping when bending your thumb, tenderness, pain, tingling and loss of sensation or strength (ASSH, 2017). Thumbs were designed primarily to stabilize objects in our hands. Therefore, they should not be used for the forceful or repetitive motions frequently experienced during mobile hand-held device use. If you are experiencing pain or swelling near the base of your thumb, difficulty moving your thumb and/or wrist when you’re grasping or pinching or feel your thumb is sticking when you try to move it, you might have blackberry thumb. Doctors can perform a simple examination called the Finkelstein Test to determine whether or not you have De Quervain’s Tenosynovitis. To help protect against Blackberry Thumb, look for a phone that properly fits your hand. When the screen is too large for your hand, it can place additional strain on the thumb(s) when utilizing the device.

Cell Phone Elbow

Cubital Tunnel Syndrome also known as Cell Phone Elbow is caused by pressure ulnar nerve compression and stretching, also known as your “funny bone” nerve (ASSH, 2015). This can occur by prolonged flexion of your elbow, usually by leaning on your elbow while talking on the phone or simply holding the phone to your ear. Cell Phone Elbow can lead to numbness in fingers, tingling in hands, and/or pain in your elbow. Further to that, it can progress to hand fatigue, weakness and difficulty when gripping objects (ASSH, 2015). Symptoms of Cell Phone Elbow present themselves gradually, and treatments depend on how advanced your case of Cubital Tunnel Syndrome are. In more mild cases, anti-inflammatory medication, a split, and avoiding problematic positions have been shown to reduce the severity of symptoms. In more advanced cases, Cubital Tunnel Release – a surgical procedure – should be considered. To help protect against cubital tunnel syndrome, use voice activated features and speakerphone whenever possible. This will help you prevent holding your phone in a problematic position.

Digital Eye Strain

Digital eye strain or computer vision syndrome refers to a group of eye and vision-related problems that result from prolonged cell phone, computer or tablet use (AOA, n.d.). Poor lighting, glare, improper viewing distances and uncorrected vision problems are examples of factors that may lead to digital eye strain (AOA, n.d.). Due to the nature of digital devices we tend to hold digital devices closer to our eyes than books, which can cause tired eyes. Besides that, when using these devices our eyes constantly need to re-focus on the varying font and image sizes. It has also been reported that when you use a digital device there is less blinking indicating that your eyes are not being re-coated with tear film as frequent. The most common digital eye strain symptoms are tired, dry and itchy eyes as well as blurred vision, headaches, neck and shoulder pain (AOA, n.d.). So, how can I protect my eyes from screens? Make sure your glasses or contact prescriptions are up to date and good for using a computer. Adjust your chair and screen so that your eyes are level with the monitor, and avoid glare from windows and lights. If you can’t avoid glare altogether, get an anti-glare screen. Finally, make sure to rest your eyes. Follow the 20-20-20 rule; to reduce digital eye strain. Every 20 minutes look approximately 20 feet ahead of you for 20 seconds. This will help protect your eyes against computer vision syndrome.


Mobile hand-held devices continue to be more prevalent in our everyday lives. Therefore, it is vital to understand the risks of frequently using the devices and how prevent injury.

  • Reflect on how often you are using your mobile phone and for what tasks. Are the tasks necessary and/or could the tasks be completed with a different option
  • Make sure to take frequent breaks, stretch and avoid static postures, and monitor your digital device usage. While smartphones and computers have greatly simplified our lives, we should do our best to prevent damage to our bodies by overusing or incorrectly using them.
  • Try and use hands free or speaker options when taking phone calls for extended periods of time.
  • Make sure to set up your office with ergonomics in mind so you don’t place unnecessary strain on your body. If you have recently transitioned to working from home, contact us for a  Virtual Ergonomic Home Assessment.


  1. American Optometric Association (n.d.). Computer Vision Syndrome. Retrieved from: http://www.aoa.org
  2. American Society for Surgery of the Hand (2015). Cubital Tunnel Syndrome. Retrieved from: http://www.assh.org
  3. American Society for Surgery of the Hand (2017). De Quervain’s Tenosynovitis. Retrieved from: http://www.assh.org
  4. Fares, J., Fares, M. and Fares, Y. (2017) Musculoskeletal neck pain in children and adolescents: Risk factors and complications. Journal of Surgical Neurology International. V. 8. doi: 4103/sni.sni_445_16
  5. Hansraj KK. (2014) Assessment of stresses in the cervical spine caused by posture and position of the head. Journal of Surgical Technology International. 25:277–9. Retrieved from: https://www.ncbi.nlm.nih.gov
  6. New York Presbyterian Hospital (n.d.) How to Prevent ‘Tech Neck’. Retrieved from: https://healthmatters.nyp.org
  7. Sharan, D., Mohandoos, M., Ranganathan, R. and Jose, J. (2014) Musculoskeletal Disorders of the Upper Extremities Due to Extensive Usage of Hand-Held Devices. Journal of Occupational and Environmental Medicine. 26:22. Retrieved from: https://doi.org/10.1186/s40557-014-0022-3
  8. Statistics Canada (2017). Life in the fast lane: How are Canadians managing?, 2016. Retrieved from: https://www150.statcan.gc.ca