Could Your Smart Phone Be Ruining Your Cervical Spine?

Regular use of your smartphone may lead to preventable neck problems. 

The condition is called text neck, Smartphone neck, and iPhone neck. Note: These are not official medical diagnoses. All refer to posture problems in the cervical spine that are created by prolonged use of a cell phone, tablet, or similar handheld electronic device.

Text neck risk position.
Christopher Kimmel / Getty Images

Using small electronic devices generally means you spend a lot of time with your head bent forward. The problem is—this head action actually takes place in your neck.

“People get so focused on these devices that they end up holding their neck and upper back in abnormal positions for a long period of time; enough that other people coined the phrase ‘text neck,’ which is essentially referring to postural pain,” says Chris Cornett, M.D., orthopaedic surgeon and spine specialist at the University of Nebraska Medical Center Department of Orthopaedic Surgery and Rehabilitation.

Dr. Cornett continues, “When you hold your body in an abnormal position, it can increase stress on the muscles, cause fatigue, muscle spasms, and even stress headaches."


A study by Lee and colleagues published in the October 2014 issue of Ergonomics found that repetitive or prolonged head flexion posture during smartphone use is a risk factor for neck pain. The study looked at 18 participants who performed 3 tasks with a smartphone: Texting, browsing and watching a video. Participants did these activities while sitting and also when standing.

Not only did the study identify head flexion associated with heavy smartphone use as a risk factor for neck pain, but it also found that of the 3 activities, texting may be the biggest contributing factor to device use-related neck pain. (The authors say that texting is the most frequently performed of these functions.) In the study, texting while sitting caused the largest degree of head flexion.


According to Jeremy McVay, physical therapist and owner of McVay Physical Therapy in Barrington, Rhode Island, possible symptoms of "iPhone neck" include headaches, neck pain, shoulder pain, and nerve-related symptoms such as radiating pain, numbness, tingling and/or burning in one or both arms.

A 2012 study involving 18 people conducted at Google headquarters in Mountainview, California, looked at (among other things related to tablet use) how much head flexion resulted from checking email and surfing the web. This study also measured head flexion as people watched movies on their tablet while sitting at a table.

The researchers found that participants who used the tablet without a table (i.e. with the device on their laps) had extreme head flexion. The head flexion for movie watchers at tables was less.

How to Avoid or Prevent Text Neck

Perhaps the best strategy for mitigating the effects of device usage on your neck is to raise your viewing angle. For this, there are a few things to try. You can put the tablet on a stand or on a table. If you must work with it on your lap, consider propping it up with a pillow.

And if you think holding the tablet up with your hands may reduce your head flexion angle, beware. This positioning will likely tighten up the muscles in your forearms, which can cause an entirely different type of discomfort or pain.

Dr. Cornett offers common sense approaches to avoiding text neck such as getting and staying physically fit and taking regular breaks from your device. Both strategies are excellent.

You may also consider engaging with a posture exercise program. If you can only do one exercise, we recommend cervical retraction for neck re-positioning. You might also want to try a posture exercise program.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Al-hadidi F, Bsisu I, Alryalat SA, et al. Association between mobile phone use and neck pain in university students: A cross-sectional study using numeric rating scale for evaluation of neck pain. PLoS ONE. 2019;14(5):e0217231. doi:10.1371/journal.pone.0217231

  2. Lee S1, Kang H, Shin G. Head Flexion Angle While Using a Smartphone. Ergonomics. 2014 Oct 17:1-7. [Epub ahead of print] 

  3. Muller, H., Gove, J., Webb, J., Understanding Tablet Use: A Multi-Method Exploration. Google, Inc. Mountain View, CA.

Additional Reading
  • McVay, J. DPT, CSCS, MPT, BS., Are You Developing Smartphone Neck? Patient Handout. McVay Physical Therapy, Barrington, Rhode Island. 

  • University of Nebraska Medical Center (UNMC). "Texting Becoming a Pain in the Neck." ScienceDaily. ScienceDaily, 26 February 2013. 

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.