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Text Neck Syndrome: What is it and what can we do about it?

Updated: Aug 19, 2023

hands holding phones

“Text Neck Syndrome” is a fairly new 21st century condition coined by chiropractor Dean Fishman. It describes a cluster of symptoms deriving from prolonged forward head positioning while looking at a hand-held device. It describes a muscular imbalance in which more superficial spinal/shoulder muscles are overworked and become tight while deeper postural muscles (that are crucial for stability and endurance) get lengthened and weak.

Signs and Symptoms of “Text Neck Syndrome:”

· Neck/shoulder pain and/or tightness

· Rounded shoulders

· Resting head posture shifted forward so ears are in front of your shoulders

· Headaches

The head weighs roughly 10-12lbs., and when you bend your head down, your neck has to counteract greater forces to keep your head stationary. Dr. Kenneth K. Hansraj, the Chief of Spine Surgery at New York Spine Surgery & Rehabilitation Medicine conducted a study to assess how the amount of force through the neck changes as the amount of cervical flexion (i.e. forward neck bending) increases. He found that the force going through the cervical spine can increase up to 60lbs. when flexed to 60 degrees! (See the picture below, included in the study, for more findings).

skeletons with neck posture

forces on cervical spine

(Graphic from Hansraj, K. K. (2014). Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head.)

Americans are thought to spend between 3-5 hours on their phones PER DAY, and this can be even higher with adolescents. That’s around 1800 hours or 75 days per year! Imagine how much force is going through your spine/muscles/tendons/ligaments/etc. for that long!

When placed in these exaggerated postures frequently and for extended periods, maladaptive changes can start to occur and other problems may develop. These can include:

· Alteration in the natural curvature of your spine which can impact cardiovascular health.

· TMD (temporomandibular dysfunction) due to extra stress on jaw and chewing musculature.

· Eye strain.

· Rib hypomobility due to rounded posture thus impacting breathing patterns and lung health.

· Increased spinal arthritic changes due to abnormal forces through joints.

· Spinal disc herniation or compression; may include neural symptoms (radiating pain, numbness, and/or tingling).

spine with forward head


So now that we know how detrimental “Text Neck Syndrome” can be, what can we do to fix it and/or prevent this from happening in the first place??

Although the answer to this question is going to vary based on the individual’s symptoms, there are a few postural techniques we commonly suggest:

· When using an electronic device, aim to position it at eye-level so you are not bending forward.

· Whether you are scrolling through social media on your phone or working at a computer, aim to take frequent breaks to “reset” your posture (i.e. stand up and take a lap around your desk, do 10 reps of one of the exercises listed below).

· Regularly participate in relaxation exercises (deep breathing, meditation, etc.) as stress can exacerbate your symptoms.

· Implement a strengthening program that targets your deep stability muscles in order to improve your postural endurance.

In addition to these postural techniques, here are 3 exercises that can be implemented throughout the day to help “retune” your posture:

cervical retraction exercise

1. Cervical retraction: Sitting up tall with your chin in neutral, slide your chin back as if you are a turtle going back in its shell. Hold for 3-5 seconds, relax, then repeat.

scapula retraction exercise

2. Scapular retraction: With arms by your side, gently move your shoulders back and squeeze your shoulder blades together. Hold for 3-5 seconds, relax, then repeat.

thoracic extension exercise

3. Thoracic extension: Sitting in a straight back chair, shift your hips back so that your hips and spine are in contact with the back of the chair (you may need to place each leg on either side of the chair). Cross your arms above your chest and, keeping your chin tucked, arch back over the back of your chair (Ideally your chair back will be resting just below your shoulder blades). Repeat.

It’s important to note that not all exercises are appropriate for everyone, so be sure to consult with your PT prior to implementing a new exercise regimen.


Article: Hansraj, K. K. (2014). Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head. Surgical Technology International, XXV, 277–279.

David, D., Giannini, C., Chiarelli, F., & Mohn, A. (2021). Text neck syndrome in children and adolescents. International Journal of Environmental Research and Public Health, 18(4), 1565.

All exercise pictures obtained via

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