People have been looking down to read and write for centuries. So why has this suddenly become a problem? A closer look at the studies, and what genuinely helps.
You have probably heard of “tech neck” or “text neck”, the idea that looking down at your phone damages your spine. It is worth examining properly, because there is something in it, though perhaps not quite what the headlines suggest.
What the studies show
A study published in the Journal of Spine Surgery examined the effect of mobile phones on neck alignment in young adults and the mechanical loads involved. The X-rays showed greater mechanical loading, particularly in the upper cervical spine, and this was considerably more pronounced when sitting than when standing.
Further work, including a study in the Journal of Orthopaedic Science, has demonstrated that young people who use mobile phones excessively are more likely to experience neck pain than those who do not. Excessive phone use has also been linked to greater wear and tear in the spine, particularly disc degeneration.
These studies demonstrate an association. We should be careful in how we interpret them. They are largely observational, and so do not necessarily account for other lifestyle factors that may be contributing.
The obvious counterargument
People have been looking down to read, write and work for centuries, if not millennia. So why should this suddenly be a problem?
There is an interesting historical wrinkle here. Look at Renaissance paintings of people reading and you will almost invariably find the text propped on a lectern or held at an angle. Also feather quills dipped in ink for writing were less likely to smudge and blanch with the paper at an angle. The flat desk seems to arrive properly with the clerical work of the Industrial Revolution, when enormous volumes of paper made it the practical option. Neck comfort was not the consideration; practicality was.
My view: it comes down to exposure
I have certainly noticed in my own practice an increasing number of younger people with neck pain and degenerative changes in the spine.
Our spines tolerate heavy loads perfectly well. I think the real issue is duration.
When we read a book, our concentration span imposes its own limit. We look up. We shift position. We move around, often without intending to. Heavy phone users spend far longer with the head continuously flexed than the average reader or office worker ever did.
It is also worth saying that degenerative changes in the cervical spine are very common findings on X-ray, and are not independently associated with neck pain. A scan showing wear and tear does not, on its own, explain your symptoms.
What actually helps
I have often been critical of the concept of posture when discussing the lumbar spine. The answer is not to stop slouching and sit bolt upright. It is to get up and move about every so often. The same principle applies to the neck.
So despite the caveats above, I do think less time on your phone is better, and largely for your general health. But the useful change is not holding your neck rigidly upright while you use it. It is taking short breaks from it regularly.
The key takeaway
Your spine is a strong and robust structure. Trying to understand it is far more helpful than trying to hold it perfectly.
