Is Your Phone a Pain in the Neck?

Occupational Health Clinic
February 2, 2018

Dr. Jacob Schwarz, Director of the Spine Center and Assistant Professor ​of the Department of Neurological Surgery, speaks with Occupational Health about "text neck."

Begin Transcript

Welcome to this edition of the Vanderbilt Health and Wellness Wellcast.  I am Tanicia Haynes with Occupational Health.  Dr. Jacob Schwarz, Director of the Spine Center and Assistant Professor of the Department of Neurological Surgery, is speaking with us today about "text neck."  Hello, Dr. Schwarz.

Dr. Jacob Schwarz:  Hello.

Tanicia Haynes:  Today, we all have phones, and we all kind of are in our phones texting or playing games, making phone calls, and recently, we have heard about something about "text neck."  Could you tell us more about that?

Dr. Jacob Schwarz:  Sure.  "Text neck," or sometimes it is called "tech neck," is this phenomenon where we are seeing increasing numbers of people who have daily neck pain, and we believe that is attributed to the time that we spend with our head flexed, looking down at these devices, you know, initially texting into keyboards like a Blackberry, but now looking into smartphones and holding your neck in a position that it is not accustomed to being in.

Tanicia Haynes:  So, what happens when people do this with their neck and keep their neck in this position?

Dr. Jacob Schwarz:  Well, I think it is important to realize that we are engineered to stand upright and to look directly ahead, and that our body is very happy as long as everything is in appropriate balance, but when we come out of that balance, whether it is leaning too far forward or holding an arm in an odd position for too long, the joints and the muscles associated with that imbalance start to hurt.  So, in the instance of tech neck, what is happening is that we are looking into our smartphone that we are holding, usually close to our chest and close to our head beneath our chin, and that requires us to look down into the device.  As a result, we are still standing upright, but we are tilting our head forward and that brings our head in front of our center of balance, and it flexes our neck more than we are used to.  As a result of that, muscles that usually don't have to work so hard to keep our head still, have to work more.  So, if you think about it, if your head is leaning forward, there has to be an opposite force to keep your head back a little bit, or else our head would just continue to lean forward and our body would fall forward.  So, the muscles in the back of our neck start to pull our head back and then have to hold it in that isometric contraction for longer than usual.  So, as a result of that, people develop a fair amount of neck pain.  Now, over a long period of time, if you hold an abnormal position, it is not just the muscles that can change; it is the joints that can change as well, and the joints become inflamed, and when they do that, that can create a painful condition.

Tanicia Haynes:  So, if people do start to feel this neck pain that is more associated with the use of their devices, what kind of treatment would happen to kind of get rid of this or make this feel better?

Dr. Jacob Schwarz:  The most important thing is always recognizing the problem.  So, if the description that we have provided sounds like you, you might think, "Well, do I have a lot of neck pain that I otherwise didn't have," and, "Am I spending more time looking down at my smartphone than I have in the past?"  That correlation can tell you that you need to change something.  So, what needs to change is you need to spend more time in your natural position.  It is really all about the ergonomics.  So, we have to do something, either to get you to quit looking at your phone, or if you have to look at your phone or your device, to get that into a position where your body is in its usual, neutral alignment.  We see this, for instance, with people who work at computer screens at a desk.  If you are at an abnormal position with your head turned too far to the side or bent too far forward, just moving the monitor to a better location can make all the difference in the world.  Things like using your phone in a seated position where you can hold the phone upright can make a big difference, using the phone very sparingly for short periods of time, being very mindful of how much time you are spending looking at your phone.  I know I fall victim to this myself, just walking back from one part of the hospital to another, I might recognize I have covered hundreds of yards looking at my phone.  So, that was a big distance and a long period of time that I had my neck bent unnaturally.  When my neck starts to hurt, I put the phone away, stand up and walk normally, and very often I will start to feel better.  And if you make a pattern of doing that over a long period of time, this pain that has slowly crept up on you will slowly recede  as well.

Tanicia Haynes:  So, wonderful.  So, it sounds like we can still use our devices, but maybe just making little changes in the way and the manner of our positioning and our posture can maybe help the situation out a lot better.

Dr. Jacob Schwarz:  That is absolutely true.  I think having self-awareness about how often you are using them and how much time you are spending in this abnormal position can make all the difference.

Tanicia Haynes:  Well, wonderful.  Thank you so much, Dr. Schwarz, for speaking with us.  We really appreciate that.

Dr. Jacob Schwarz:  It is my pleasure.  Thank you for having me.

Tanicia Haynes:  Thanks for listening.  Please feel free to leave us any comments on this Wellcast on the form at the bottom of this page.  If you have a story suggestion, please email it to us at, or you can use the "Contact Us" page on our website at