Does ‘Text neck’ Cause Neck Pain?
Forward Head Position (FHP), commonly known as ‘text-neck’, is often cited as being one of the leading causes of neck pain but the little research that has explored this topic is inconclusive.
A recent study by Damasceno et al (2018) did not show an association between ‘text neck’ and neck pain in young adults aged 18 to 21. A systematic review and meta-analysis by Sheikhhoseini et al (2018) reports that the precise nature of the relationship between FHP and musculoskeletal pain remains to be established.
Very little is known about the causes of neck pain. The epidemiologic studies do not reveal either the source or the cause of pain.
In reality, FHP is the head posture we humans adopt when we’re looking at something held in our hands. Look at this drawing of people in the Victorian times reading newspapers and books.
Victorian people with "forward head position"
Although certain occupations such as office and computer workers, manual laborers, and health care workers, have been found in some studies to have a higher incidence of neck pain, the major work-place factors associated with the condition are low job satisfaction and perceived poor work-place environment (Côté et al 2009).
My take on this controversial topic is that it may be a more efficient use of our time and energy to focus on mobilizing the head and neck regularly instead of focusing on our static head and neck posture. A study by Kim et al (2018) found that the occurrence of cervical area pain was higher amongst subjects who had a decreased CVJ (craniovertebral junction) and flexion motion.
Lewis (2011) sums up this topic perfectly:
“It is surprising how little evidence there is to support the existence of an ideal posture of the head, neck, thorax… that rehabilitation can correct posture that is considered abnormal, and the idea that this correction leads to an improvement in function and a reduction in pain. There is evidence to challenge these concepts which suggests that the certainty with which this aspect of clinical practice is taught to undergraduate and postgraduate students and imparted to patients and clients requires robust research enquiry.”
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References:
Côté, P., van der Velde, G., Cassidy, J., Hogg-Johnson, S. et al. (2009) ‘The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.’ J Manipulative Physiol Ther 32, 2, S70-S86.
Damasceno, G., Ferreira, A., Nogueira, L., Reis, F., Andrade, I. and Meziat-Filho, N. (2018) ‘Text neck and neck pain in 18 to 21-year-old young adults.’ European Spine Journal 27, 1249–1254.
Kim, D., Kim, C. and Son, S. (2018) ‘Neck Pain in Adults with Forward Head Posture: Effects of Craniovertebral Angle and Cervical Range of Motion.’ Osong Public Health and Research Perspectives 9, 6, 309–313.
Koseki, T., Kakizaki, F., Hayashi, S., Nishida, N. and Itoh, M. (2019) ‘Effect of forward head posture on thoracic shape and respiratory function.’ J Phys Ther Sci 31, 63–68.
Lewis J. (2011) ‘Subacromial impingement syndrome: a musculoskeletal condition or a clinical illusion?’ Physical Therapy Reviews 16, 5, 388-398.
Sheikhhoseini, R., Shahrbanian, S., Sayyadi, P. and O’Sullivan, K. (2018) ‘Effectiveness of Therapeutic Exercise on Forward Head Posture: A Systematic Review and Meta-analysis.’ J Manipulative and Physiological Therapeutics 41, 6, 530-539.