“Hey, what’s up?” It’s late at night and you’re in bed with your neck pressed against the headboard so you can see your phone. Welcome to text neck.

As you begin, you look down at your phone to the barrage of text messages. Soon before you realize it, you’ve been looking down with your neck in a flexed (bent) position for anywhere close to 10 minutes plus. Like most people, you’re probably repeating this throughout the day in some capacity, be it at work and looking down at your phone, walking and texting, not realizing the effects on your neck. This flexed position places a great deal of stress on your neck, specifically the discs.

Technology is affecting our health

Studies show that 51-67% experience neck pain. Disc herniation has a nearly 1:1 female: male incidence. Under 40 years of age poses a greater risk for a disc herniation.

The vertebrae in your neck are separated by discs which act as shock absorbers. Adjacent to the discs are spinal nerve roots that exit the spinal cord. Repeated forward bending of the neck will exert a pressure on the discs. While your discs are equipped to handle such pressures, these repeated motions and poor neck posture will gradually catch up with you, potentially leading to disc herniations and pinched nerves and you may experience some of the following symptoms: sharp aching burning pain in the neck, radiating down the arm, sometimes accompanied by numbness and tingling, weakness, “fallen asleep” sensation in the hand.

While degenerative disc disease (DDD) can result in the same condition, it is generally an age related process. Largely up to 90% of the cases of text neck will resolve with conservative care (heat/ice, massage), rest and over the counter nonsteroidal anti-inflammatory drugs (NSAIDs-ibuprofen, naproxen) will help alleviate the pain. You should note that while rest is recommended in the initial stages of recovery, total bed rest is detrimental to the healing process as your inactive muscles can atrophy and joint stiffness may arise. Short periods of bedrest followed by light, non-aggravating activity are encouraged.

Do I have text neck?

Millennial Magazine- text neck

If your symptoms do not subside in a reasonable time frame, up to two weeks, or they worsen, you should seek a proper evaluation by a medical doctor, preferably one with expertise in musculoskeletal medicine such as pain medicine specialist/or a physiatrist who will perform a thorough and focused physical examination addressing potential triggers for your symptoms.

Your doctor may ask you to have some diagnostic testing performed, such as X-rays, MRI- to evaluate the disc integrity and detect level of herniation, and electromyography/nerve conduction studies-to evaluate nerve function and pinpoint a lesion on a nerve affected by the disc herniation. Generally speaking, text neck does not require additional testing unless your doctor is concerned for an underlying medical illness that can cause or mimic these symptoms.

On occasion, you may require stronger medication such as oral steroids and muscle relaxers or minimally invasive procedures such as an epidural injection. Contrary to common practices, opiate medication (oxycodone, Percocet®, Vicodin®) should not be prescribed as a first line treatment. This will be accompanied by a course of physical therapy so you can improve your range of motion, learn and understand the principles of proper neck posture and focused neck exercise to strengthen the surrounding supportive muscles to prevent future occurrences of ‘text neck.’ It is imperative that you adhere to home exercise regimens as designed by your physical therapist.

What if I do nothing?

If left untreated, the condition may worsen and you may experience other signs and symptoms such as bowel and bladder dysfunction, pronounced weakness and intractable pain. Should all the above treatments fail to control your symptoms adequately, your doctor may recommend you for further surgical evaluation.

Some preventative measures for text neck include general state of well-being by eating healthy, maintaining a healthy weight range, smoking cessation, exercising regularly-incorporating proper strengthening and flexibility conditioning programs, avoid sudden sharp neck twisting and bending, repetitive flexion motions and keep your neck at a neutral natural angle for good neck posture. Nontraditional exercises such as yoga are a great way to lengthen the spine and stretch the muscles. As always, first check with your primary care doctor about intensity and level of exercise.

You should try to minimize life and work related stressors as this can amplify your pain. Deep breathing, relaxation techniques are a great way to help reduce your daily stress. This type of pain condition typically resolves in a short time period. If the pain is overwhelming, you might want to consider short term counseling for coping strategies on pain perception and management and set reasonable time based goals until the condition improves. Consider alternatives to texting, phone or video chat when possible. Overall, try to keep your phone at eye level so you don’t place unnecessary strain on your neck. Safe texting

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Joseph Hadi, M.D.


New York, NY

Dr. Joseph Hadi currently works at New York City’s Stanford Pain & Sports Medicine. He attended Yeshiva University and subsequently Sackler School of Medicine. Dr. Hadi loves to teach and inform his patients of their conditions. He believes, "an educated patient, is a healthier patient." His interests lie in the field of neuro ablation to promote long term pain relief.

All posts by Joseph Hadi, M.D.

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