Jeffrey R. Carlson, MD
The next time you are out in a crowded public place, take a moment and look around you. Pay special attention to the people you see and what they are doing. I would guess that 8 out of 10 are looking at an electronic device, with their head and neck tilted down at an unnatural angle, peering at a screen. Alternatively, they may be talking on the phone, with it precariously wedged between their ear and their shoulder, trying to apply just the right amount of pressure to keep it from falling as do other tasks while talking. When you are at work, do you sit in front of a computer all day, probably without the best posture and a not-so-great ergonomic position? Exactly how many hours a day is your neck bent forward looking at an electronic device of some kind? Is it any wonder why our necks and shoulders ache and hurt?
Medical professionals these days now are affectionately calling these aches and pains “Tech Neck” or “Text Neck”, due to their association with newer technologies involving phones, tablets and other personal electronic devices. Really, tech neck is a new name for an old problem – overuse and repetitive strain to the soft tissues and muscles in the neck, surrounding the cervical spine. Sometimes, this pain can even migrate into the shoulders and upper back.
When a patient comes to see me for persistent pain in their neck and possibly upper back and shoulders, I will order x-rays, do a physical exam and ask a lot of questions about the patient’s work, activity level, interests, etc. If their x-rays come back negative for any structural issues or degenerative issues, such as arthritis, I will definitely suspect something muscular in nature. I will ask the patient to demonstrate a variety of range of motion exercises that will usually give me the answer that I am seeking. When they tell me that they spend a lot of time on their phone, on social media or gaming, we are off to the races.
Now, treatment is another issue. When I tell the patient that they need to change their behavior and stop using their tech devices so much, you would think that I had asked them to give up breathing or eating. A look of sheer panic crosses their face that is really something to behold. Typically, I know that this recommendation while be ignored, so I also recommend Physical Therapy so that they can build strength, restore range of motion and help their overused muscles and tissues time to heal. The Physical Therapist has specialized modalities, such as ultrasound and laser therapy, functional dry needling and other treatments to move the recovery process along. I may order a dose of oral steroids and or muscle relaxants for really inflamed muscles, but the pain should be controllable with OTC Naproxen Sodium or Ibuprofen. Heat/ice therapy may be helpful, as is massage. Regular exercise, stretching the body away from that forward, hunched-over position and doing anything other than looking down at a screen will be beneficial for healing the neck.
I also recommend that the patient look at how they are using technology at work and at home. All screens should be at eye level to prevent neck strain and fatigue. If the patient wants to use their personal electronic devices often, they need to ensure they can do so safely without causing further damage to their necks. Long term and left untreated, tech neck could lead to an increased risk of cervical spine issues, such as arthritis or degenerative disc disease.